Intracranial arteriosclerosis and the risk of dementia: A population-based cohort study

被引：13
作者：
van den Beukel, Tim C. [1 ,2 ,3 ]
Wolters, Frank J. [1 ,4 ,5 ]
Siebert, Uwe [6 ,7 ,8 ,9 ,10 ]
Spiering, Wilko [11 ]
Ikram, M. Arfan [1 ]
Vernooij, Meike W. [1 ,2 ]
de Jong, Pim A. [3 ]
Bos, Daniel [1 ,2 ,12 ]
机构：
[1] Erasmus MC, Dept Epidemiol, Rotterdam, Netherlands
[2] Erasmus MC, Dept Radiol & Nucl Med, Rotterdam, Netherlands
[3] Univ Med Ctr Utrecht, Dept Radiol & Nucl Med, Utrecht, Netherlands
[4] Erasmus MC, Dept Neurol, Rotterdam, Netherlands
[5] Erasmus MC, Alzheimer Ctr, Rotterdam, Netherlands
[6] Harvard TH Chan Sch Publ Hlth, Ctr Hlth Decis Sci, Dept Epidemiol, Boston, MA USA
[7] Harvard TH Chan Sch Publ Hlth, Ctr Hlth Decis Sci, Dept Hlth Policy & Management, Boston, MA USA
[8] UMIT TIROL Univ Hlth Sci & Technol, Dept Publ Hlth, Hlth Serv Res & Hlth Technol Assessment, Inst Publ Hlth,Med Decis Making & Hlth Technol As, Hall in Tirol, Austria
[9] Harvard Med Sch, Program Cardiovasc Res, Inst Technol Assessment, Boston, MA USA
[10] Harvard Med Sch, Massachusetts Gen Hosp, Dept Radiol, Boston, MA USA
[11] Univ Med Ctr Utrecht, Dept Vasc Med, Utrecht, Netherlands
[12] Harvard TH Chan Sch Publ Hlth, Dept Epidemiol, Boston, MA USA
来源：
ALZHEIMERS & DEMENTIA | 2024年 / 20卷 / 02期
关键词：
arterial calcification; arteriosclerosis; cohort study; dementia; epidemiology; SMALL VESSEL DISEASE; ALZHEIMERS-DISEASE; ARTERIAL CALCIFICATION; COGNITIVE IMPAIRMENT; PREVALENCE; STROKE; CRITERIA; ATHEROSCLEROSIS; ROTTERDAM; DIAGNOSIS;
D O I：
10.1002/alz.13496
中图分类号：
R74 [神经病学与精神病学];
学科分类号：
摘要：
BACKGROUND: The impact of intracranial arteriosclerosis on dementia remains largely unclear. METHODS: In 2339 stroke-free and dementia-free participants (52.2% women, mean age 69.5 years) from the general population, we assessed intracranial carotid artery calcification (ICAC) and vertebrobasilar artery calcification (VBAC) as proxy for arteriosclerosis. Associations with dementia were assessed using Cox models. In addition, indirect effects through cerebral small vessel disease (cSVD) and subcortical brain structure volumes were assessed using causal mediation analyses. RESULTS: During a median of 13.4 years (25th-75th percentiles 9.9-14.5) of followup, 282 participants developed dementia. Both ICACpresence (hazard ratio [HR]: 1.53, 95% confidence interval [CI]: 1.00-2.32]) and volume (HR per standard deviation: 1.19, 95% CI: 1.01-1.40) increased dementia risk. For VBAC, severe calcifications increased dementia risk (HR for third vs first volume tertile: 1.89, 95% CI: 1.00-3.59). These effectsweremediated partly through increased cSVD (percentage mediated for ICAC: 13% and VBAC: 24%). DISCUSSION: Intracranial arteriosclerosis increases the risk of dementia.
引用
收藏
页码：869 / 879
页数：11
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