Intracranial atherosclerosis and dementia

Jennifer L. Dearborn, Yiyi Zhang, Ye Qiao, Muhammad Fareed K. Suri, Li Liu, Rebecca F Gottesman, Andreea M. Rawlings, Thomas H. Mosley, Alvaro Alonso, David S. Knopman, Eliseo Guallar, Bruce A Wasserman

Research output: Contribution to journalArticle

Abstract

Objective: To explore the association of intracranial atherosclerotic disease (ICAD) with mild cognitive impairment (MCI) and dementia. Methods: From 2011 to 2013, 1,744 participants completed high-resolution vessel wall MRI from the population-based Atherosclerosis Risk in Communities Study by a sampling strategy that allowed weighting back to the cohort. We defined ICAD by plaque features (presence, territory, stenosis, number). Trained clinicians used an algorithm incorporating information from interviews and neuropsychological and neurologic examinations to adjudicate for MCI and dementia. We determined the relative prevalence ratio (RPR) of MCI or dementia after adjusting for risk factors at midlife using multinomial logistic regression. Results: A total of 601 (34.5%) participants had MCI (mean age ± SD, 76.6 ± 5.2 years), 83 (4.8%) had dementia (79.1 ± 5.3 years), and 857 (49.1%) were current or former smokers. Anterior cerebral artery (ACA) plaque (adjusted RPR 3.81, 95% confidence interval [CI] 1.57-9.23), >2 territories with plaque (adjusted RPR 2.12, 95% CI 1.00-4.49), and presence of stenosis >50% (adjusted RPR 1.92, 95% CI 1.01-3.65) were associated with increased prevalence of dementia in separate models. Posterior cerebral artery plaque was associated with MCI but did not reach statistical significance for dementia (adjusted RPR MCI 1.43, 95% CI 1.04-1.98; adjusted RPR dementia 1.58, 95% CI 0.79-2.85). There were no associations with middle cerebral artery atherosclerotic lesions or cognitive impairment. Many participants had plaque in >1 territory (n = 291, 46%) and participants with ACA plaques (n = 69) had the greatest number of plaques in other territories (mean 6.0, SD 4.4). Conclusions: This study demonstrates associations between ICAD and clinical MCI and dementia.

Original languageEnglish (US)
Pages (from-to)1556-1563
Number of pages8
JournalNeurology
Volume88
Issue number16
DOIs
StatePublished - Apr 18 2017

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ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Dearborn, J. L., Zhang, Y., Qiao, Y., Suri, M. F. K., Liu, L., Gottesman, R. F., Rawlings, A. M., Mosley, T. H., Alonso, A., Knopman, D. S., Guallar, E., & Wasserman, B. A. (2017). Intracranial atherosclerosis and dementia. Neurology, 88(16), 1556-1563. https://doi.org/10.1212/WNL.0000000000003837