Dementia and Geriatric Cognitive Disorders

Baradaran H.a· Dahlstrom K.A.a· Culleton S.a· Sarrami A.H.b· McFarland M.M.c· Romero J.R.d

Author affiliations

aDepartment of Radiology & Imaging Sciences, University of Utah, Salt Lake City, UT, USA
bDepartment of Radiology, Stanford University School of Medicine, Stanford, CA, USA
cEccles Health Sciences Library, University of Utah, Salt Lake City, UT, USA
dDepartment of Neurology, Boston University School of Medicine, Boston, MA, USA

Dement Geriatr Cogn Disord

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Article / Publication Details

First-Page Preview

Received: June 30, 2022
Accepted: August 24, 2022
Published online: October 31, 2022

Number of Print Pages: 9
Number of Figures: 3
Number of Tables: 0

ISSN: 1420-8008 (Print)
eISSN: 1421-9824 (Online)

For additional information: https://www.karger.com/DEM

Abstract

Background: Extracranial carotid atherosclerosis has been variably associated with dementia. Prior studies have focused on the association of carotid intima media thickness or carotid stenosis; however, there is evidence that carotid plaque may contribute to dementia, perhaps via microembolic phenomena. Objectives: We sought to evaluate the role of carotid plaque in contributing to cognitive impairment by performing a systematic review and meta-analysis to summarize the association between extracranial carotid plaque and cognitive dysfunction and dementia. Methods: We performed a comprehensive literature search evaluating the association of extracranial carotid plaque with cognition. We included studies measuring carotid plaque on ultrasound, computed tomography, or MR and also evaluated cognition through neuropsychological testing. Meta-analyses with assessment of study heterogeneity and publication bias were performed. Results were presented in a forest plot and summarized using a random-effects model. Results: After screening 1,674 studies, we included 40 for systematic review and 16 and 7 studies for two meta-analyses with a total of 19,029 and 27,325 patients, respectively. We found a positive relationship between the presence of extracranial carotid plaque and cognitive dysfunction with a pooled random-effects odds ratio (OR) of 1.83 (95% CI, 1.50, 2.24) and a pooled random-effects hazard ratio (HR) of 1.47 (95% CI, 1.15, 1.89), respectively. A sensitivity analysis of only longitudinal studies found a persistent positive association. Measures of heterogeneity showed moderate heterogeneity in each meta-analysis, respectively (I-squared statistic = 57% and 70%). Conclusion: The presence of extracranial carotid plaque is significantly associated with cognitive dysfunction and dementia in both cross-sectional and longitudinal analyses. After further confirmation, our results support carotid plaque being a potentially modifiable risk factor in the development of dementia.

© 2022 S. Karger AG, Basel

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First-Page Preview

Received: June 30, 2022
Accepted: August 24, 2022
Published online: October 31, 2022

Number of Print Pages: 9
Number of Figures: 3
Number of Tables: 0

ISSN: 1420-8008 (Print)
eISSN: 1421-9824 (Online)

For additional information: https://www.karger.com/DEM

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