Carotid plaque as a predictor of dementia in older adults: the Three-City Study
Laure Carcaillon1, Matthieu Plichart2, Mahmoud Zureik3
1Inserm, CESP Centre for Research in Epidemiology and Population Health, UMR-S1018, Hormones and Cardiovascular Disease, University Paris Sud, Villejuif, France.
Background:
The contribution of carotid atherosclerosis to incident dementia remains unclear. We examined the association between carotid plaques (CP) and common carotid intima media thickness (CCA-IMT) with incident dementia and its subtypes, and their added value for dementia risk prediction.
Methods:
At baseline, 6025 dementia-free subjects aged 65-86 years underwent bilateral carotid ultrasonography measures of CP and plaque-free CCA-IMT. Subjects were followed-up over 7 years for the detection of dementia.
Results:
After a mean 5.4 years of follow-up, 421 subjects developed dementia including 272 Alzheimer's disease and 83 vascular/mixed dementia (VaD). Only CP were independently related to VaD (HR(≥2 sites with plaques) = 1.92; 95% confidence interval or CI = 1.13-3.22) and improved VaD risk prediction (continuous Net Reclassification Index = 30.1%; 95% CI = 8.4-51.7) beyond known dementia risk factors. Accounting for stroke or competing risk by death marginally modified the results.
Conclusion:
In older adults, CP are independent predictors of incident VaD and may improve VaD risk prediction.
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