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(Stroke. 1996;27:1290-1295.)
© 1996 American Heart Association, Inc.

Articles

Ultrasonographic Assessment of Carotid Wall Characteristics and Cognitive Functions in a Community Sample of 59- to 71-Year-Olds

A. Auperin, MD; C. Berr, MD, PhD; C. Bonithon-Kopp, MD, PhD; P.-J. Touboul, MD; I. Ruelland, MD; P. Ducimetiere, PhD; A. Alperovitch, MD for the EVA Study Group

INSERM U360, Hopital de la Salpetriere (A. Auperin, C.B., A. Alperovitch), INSERM U258, Hopital Broussais (C.B.-K., P.D.), and the Service de Neurologie, Hopital Saint Antoine (P.-J.T.), Paris; and Centre EVA (I.R.), Nantes, France.

Correspondence to C. Berr, INSERM U360, Hopital de la Salpetriere, 47 Blvd de l'Hopital, 75651 Paris Cedex 13, France.

Background and Purpose This study was aimed at analyzing cross-sectional relationships between cognitive performance and ultrasonographic assessment of carotid wall characteristics.

Methods A cohort of 1279 subjects (men, 41%) aged 59 to 71 years was recruited from the electoral rolls of the city of Nantes (western France). Cognitive performances were evaluated with the Mini-Mental State Examination (MMSE) and seven neuropsychological tests assessing attention, psychomotor rapidity, verbal abilities, memory, and visuospatial perception. For each test, subjects were classified into three performance levels with a quartile distribution: 25% highest, 25% lowest, and 50% middle. The intima-media thickness of common carotid arteries and the presence of plaques in the carotid arteries were assessed with B-mode ultrasound examination.

Results Only 28% of men and 17% of women had carotid plaques inducing moderate stenosis of the lumen (<40%). After adjustment for possible confounders, odds ratios for poor cognitive performance associated with plaques were above 1 for all cognitive tests in men. This association was statistically significant for the MMSE and another test assessing attention skills. There was a slight association between increase of the common carotid intima-media thickness and poor cognitive scores in men with plaques. In women, no association was found between cognitive functions and presence of plaques or intima-media thickness.

Conclusions This study indicated a moderate association between atherosclerosis of the carotid arteries and poor cognitive functioning in men aged 59 to 71 years. In view of these moderate cross-sectional results, further studies are required to better assess the relationship between carotid atherosclerosis and cognitive impairment.

Key Words: aging • atherosclerosis • carotid arteries • cognition • epidemiology

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