journal articles
LONGITUDINAL ASSOCIATIONS OF CAROTID ARTERY STIFFNESS WITH PROGRESSION OF CEREBROVASCULAR DISEASE, INCIDENT DEMENTIA AND COGNITIVE DECLINE IN OLDER ADULTS
Caroline Robert, Lieng-Hsi Ling, Eugene S.J. Tan, Narayanaswamy Venketasubramanian, Shir Lynn Lim, Lingli Gong, Josephine Lunaria Berboso, Arthur Mark Richards, Christopher Chen, Saima Hilal, Josephine Lunaria Berboso, Arthur Mark Richards, Christopher Chen, Saima Hilal
BACKGROUND: Carotid artery stiffness is associated with cerebrovascular disease (CeVD) and cognitive impairment, but evidence for its longitudinal effects on progression of CeVD and cognitive decline are limited.
OBJECTIVES: To evaluate the longitudinal associations of carotid artery stiffness with CeVD progression, incident dementia, and cognitive decline.
DESIGN: Longitudinal analyses from a memory-clinic cohort with a follow-up of 2 years.
SETTING: A memory-clinic study.
PARTICIPANTS: 194 participants (mean age=80, 63 % female) with or without cognitive impairments provided consent to take part in the study.
MEASUREMENTS: Participants underwent carotid ultrasonography, brain MRI, and neuropsychological assessments were at baseline and follow-up. Carotid stiffness measures included ß-index, elastic modulus (Ep), and pulse wave velocity-ß (PWV-ß). CeVD markers included white matter hyperintensities (WMH), lacunes, cerebral microbleeds (CMBs) and cortical infarcts. Cognition was assessed with a neuropsychological battery.
RESULTS: After 2 years, incident CeVD cases included lacunes (15.7 %), CMBs (23.8 %), and cortical infarcts (7.6 %). ß-index (ß=0.78, p < 0.001), Ep (ß=0.94, p < 0.001), and PWV-ß (ß=0.15, p = 0.003) were independently associated with WMH progression. Ep (ß=-0.15, p = 0.007) and PWV-ß (ß=-3.68, p = 0.007) were independently associated with visuomotor speed decline. No association was found with incident lacunes, CMBs or dementia.
CONCLUSION: Carotid stiffness progression is associated with WMH progression and visuomotor speed decline.
CITATION:
Caroline Robert ; Lieng-Hsi Ling ; Eugene S.J. Tan ; Narayanaswamy Venketasubramanian ; Shir Lynn Lim ; Lingli Gong ; Josephine Lunaria Berboso ; Arthur Mark Richards ; Christopher Chen ; Saima Hilal (2025): Longitudinal associations of carotid artery stiffness with progression of cerebrovascular disease, incident dementia and cognitive decline in older adults. The Journal of Prevention of Alzheimer’s Disease (JPAD). https://doi.org/10.1016/j.tjpad.2025.100127