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Published on: April 23, 2021
Intracranial artery calcifications: Risk factors and association with cardiovascular disease and cognitive function
Nienke M S Golüke1, Esther J M de Brouwer1, Annemarieke de Jonghe2
1University Medical Center Utrecht, Utrecht University, Department of Geriatrics, Utrecht, The Netherlands; Tergooi Hospital, Department of Geriatrics, Blaricum, The Netherlands.
Insights
Most memory clinic patients have intracranial artery calcifications. These calcifications are linked to cardiovascular disease like stroke and heart attack, but not to cognitive decline.
Area of Science:
- Neurology
- Cardiology
- Geriatrics
Background:
- Clinical outcomes of arterial calcifications remain poorly understood.
- Intracranial artery calcifications are common, particularly in older adults.
Purpose of the Study:
- To investigate risk factors for intracranial artery calcifications.
- To examine the association between these calcifications and cardiovascular disease.
- To determine the relationship between intracranial artery calcifications and cognitive function.
Main Methods:
- A cohort of 1992 patients from a Dutch memory clinic were analyzed.
- Intracranial internal carotid artery (iICA) and basilar artery calcifications were assessed for presence, severity, and location.
- Logistic regression was used to identify risk factors and associations with cardiovascular disease and cognitive function.
Main Results:
- The majority of patients (95%) had iICA calcifications; basilar artery calcifications were less common (8%).
- Risk factors included age, diabetes mellitus, hypertension, and smoking.
- iICA calcifications were associated with stroke, and intimal calcifications with myocardial infarction.
Conclusions:
- Intracranial artery calcifications are highly prevalent in memory clinic patients.
- Cardiovascular risk factors are differentially associated with medial or intimal iICA calcifications.
- While linked to cardiovascular events, intracranial artery calcifications were not associated with cognitive function or disorders.
Background And Aims:
we know little about clinical outcomes of arterial calcifications. This study investigates the risk factors of intracranial artery calcifications and its association with cardiovascular disease and cognitive function.
Methods:
patients were recruited from a Dutch memory clinic, between April 2009 and April 2015. The intracranial internal carotid artery (iICA) and basilar artery were analysed on the presence of calcifications. Calcifications in the iICA were also assessed on severity and location in the tunica intima or tunica media. Using logistic regression, risk factors of intracranial artery calcifications were analysed, as well as the association of these calcifications with cardiovascular disease, cognitive function and type of cognitive disorder (including subjective cognitive impairment, mild cognitive impairment and dementia). Cognitive function was assessed with the Cambridge Cognitive Examination.
Results:
1992 patients were included (median age: 78.2 years, ±40% male). The majority of patients had calcifications in the iICA (±95%). Basilar artery calcifications were less prevalent (±8%). Risk factors for cerebral intracranial calcifications were age (p < 0.001), diabetes mellitus (medial iICA, p = 0.004), hypertension (intimal iICA, p < 0.001) and basilar artery, p = 0.019) and smoking (intimal iICA, p = 0.008). iICA calcifications were associated with stroke and intimal calcifications also with myocardial infarction. Intracranial artery calcifications were not associated with cognitive function or type of cognitive disorder.
Conclusion:
the majority of memory clinic patients had intracranial artery calcifications. Cardiovascular risk factors are differentially related to medial or intimal iICA calcifications. iICA calcifications were associated with myocardial infarction and stroke, but not with cognitive outcomes.
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