Intima-Media Thickness and Cognitive Function in Stroke-Free Middle-Aged Adults: Findings From the Coronary Artery Risk Development in Young Adults Study.
Intima-Media Thickness and Cognitive Function in Stroke-Free Middle-Aged Adults: Findings From the Coronary Artery Risk Development in Young Adults Study.
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DOI：
10.1161/strokeaha.115.008994
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发表时间：
2015-08
期刊：
影响因子：
8.3
通讯作者：
Yaffe K
中科院分区：
文献类型：
--
作者：
Zeki Al Hazzouri A;Vittinghoff E;Sidney S;Reis JP;Jacobs DR Jr;Yaffe K
颈动脉内膜中层厚度(IMT)与中年认知功能之间的关系尚不清楚。我们在2747名无中风患者的中年流行病学队列中研究了IMT和认知功能之间的关系。在第20年的访问中(我们的研究基线)，来自青年冠状动脉风险发展研究的参与者进行了颈总动脉超声测量IMT。五年后，参与者完成了一组认知测试，包括言语记忆的Rey听觉-语言学习测试，加工速度的数字符号替代测试，以及执行功能的Stroop测试。我们将认知分数转换为标准化的z分数，负值表示表现较差。基线平均年龄为45.3岁(SD=3.6)。在未调整的线性回归模型(言语记忆=−0.16，95%CI=−0.20至−0.13；加工速度=−0.23，95%CI=−0.27至−0.19；执行功能=−0.17，95%CI=−0.20至−0.13)中，较大的IMT(每1SD相差0.12 mm)与所有认知测试(z分数)的较差显著相关。在调整了社会人口学和血管危险因素的模型中，较大的IMT仍然与加工速度(−0.06，95%CI=−0.09至−0.02；p=0.003)负相关，与执行功能(−0.03，95%CI=−0.07至0.00；p=0.07)负相关，但与言语记忆无关。我们观察到，在超过传统血管风险因素的中年，IMT较大和较差的处理速度之间存在关联，而处理速度是认知功能的关键组成部分。旨在预防动脉粥样硬化早期阶段的努力可能会改变认知老化的过程。
The relationship between carotid artery intima media thickness (IMT) and cognitive function in midlife remains relatively unexplored. We examined the association between IMT and cognitive function in a middle-aged epidemiologic cohort of 2,747 stroke-free participants. At the Year 20 visit (our study baseline), participants from the Coronary Artery Risk Development in Young Adults study had IMT measured by ultrasound at the common carotid artery. Five years later, participants completed a cognitive battery consisting of the Rey Auditory-Verbal Learning Test of verbal memory, the Digit Symbol Substitution Test of processing speed, and the Stroop test of executive function. We transformed cognitive scores into standardized z-scores, with negative values indicating worse performance. Mean age at baseline was 45.3 years (SD=3.6). Greater IMT (per 1SD difference of 0.12mm) was significantly associated with worse performance on all cognitive tests (z-scores) in unadjusted linear regression models (Verbal Memory=−0.16, 95%CI=−0.20 to −0.13; Processing Speed=−0.23, 95%CI=−0.27 to −0.19; and Executive Function=−0.17, 95%CI= −0.20 to −0.13). In models adjusted for socio-demographics and vascular risk factors that lie earlier in the causal pathway, greater IMT remained negatively associated with processing speed (−0.06,95%CI=−0.09 to −0.02; p=0.003) and borderline associated with executive function (−0.03, 95%CI=−0.07 to 0.00; p=0.07) but not with verbal memory. We observed an association between greater IMT and worse processing speed – a key component of cognitive functioning- at middle-age above and beyond traditional vascular risk factors. Efforts targeted at preventing early stages of atherosclerosis may modify the course of cognitive aging.