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O1–01–07: Carotid endarterectomy and stroke or TIA are associated with an increased risk of mild cognitive impairment
Author(s) -
Roberts Rosebud O.,
Cha Ruth,
Pankratz Ver S.,
Knopman David S.,
Geda Yonas E.,
Rocca Walter A.,
Petersen Ronald C.
Publication year - 2007
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2007.04.361
Subject(s) - medicine , carotid endarterectomy , stroke (engine) , dementia , odds ratio , rochester epidemiology project , population , endarterectomy , cardiology , clinical dementia rating , epidemiology , carotid arteries , population based study , disease , mechanical engineering , environmental health , engineering
Background: Severe atherosclerosis in carotid arteries may cause cerebral hypoperfusion and ischemia. Alternately, cerebral ischemia during carotid endarterectomy or resulting from a stroke may contribute to mild cognitive impairment (MCI) and the subsequent development of dementia. Objective(s): To investigate the associations of carotid endarterectomy and stroke with MCI in a population-based case-control setting. Methods: A sampling frame of Olmsted County, MN, residents aged 70 to 89 years on 10/1/2004 was constructed using the records-linkage system of the Rochester Epidemiology Project. Random samples of persons within age and sex categories were invited to participate in the study. Participants were administered the Clinical Dementia Rating Scale, the Short Test of Mental Status, a neurologic examination, and psychometric testing (to assess memory, language, visuospatial, and executive function domains). A consensus panel of neurologists, neuropsychologists, and clinical nurses reviewed information on each participant to reach a diagnosis of normal cognition, MCI, or dementia. A history of carotid endarterectomy and stroke or transient ischemic attacks (TIA) was collected via a structured interview. Results: We identified 295 MCI cases and 590 ageand sexmatched controls with normal cognition (2 to 1 matching). The frequency of carotid endarterectomy was 13/295 (4.41%) in MCI cases and 12/590 (2.03%) in controls, and the frequency of stroke or TIA was 77 (26.10%) in MCI cases and 83 (14.07%) in controls. In conditional logistic regression models adjusted for years of education, the odds ratio (OR) of MCI was 2.21 (95% CI 0.98, 4.99) in subjects with prior carotid endarterectomy compared to subjects without, and the OR was 2.15 (95% CI 1.52, 3.06) in subjects with a history of stroke or TIA compared to subjects without. Conclusions: Our findings suggest that subjects who undergo carotid endarterectomy or have a stroke or TIA may be at increased risk of MCI or dementia.