Christopher Maroules MD, Presenter: Nothing to Disclose

Jarett Berry MD, Abstract Co-Author: Nothing to Disclose

Amit Khera MD, MSc, Abstract Co-Author: Nothing to Disclose

Heidi Rossetti PhD, Abstract Co-Author: Nothing to Disclose

Kirstine Carter PhD, Abstract Co-Author: Nothing to Disclose

Mohit Kumar Gupta MD, Abstract Co-Author: Nothing to Disclose

Ronald M. Peshock MD, Abstract Co-Author: Nothing to Disclose

Roderick McColl PhD, Abstract Co-Author: Nothing to Disclose

Colby Ayers MS, Abstract Co-Author: Nothing to Disclose

Nagina Malguria MBBS, Abstract Co-Author: Nothing to Disclose

Suhny Abbara MD, Abstract Co-Author: Research Consultant, Radiology Consulting Group

Kevin S. King MD, Abstract Co-Author: Nothing to Disclose

Limited studies have explored the relationship between atherosclerosis and cognitive impairment. We sought to determine associations between subclinical atherosclerosis, cognitive screening, and white matter hyperintensities on MRI, a predictor of cognitive function.    

The study consisted of 1903 participants from the XXXXXX Heart Study (mean age 44 ± 10 years, 56% female) without cardiovascular disease who underwent carotid and brain MRI at 3 Tesla. Semi-automated techniques were used to define wall contours of the internal and common carotid arteries (ICA and CCA) and white matter hyperintensity volume (WMH). Subjects also underwent Montreal Cognitive Assessment (MoCA) testing and multidetector CT for measurement of coronary artery calcium (CAC) using the Agatston method. A MoCA score less than 26 was used to indicate the presence of at least mild cognitive impairment. Large WMH was defined as greater than 1 SD above the age-specific median. We related CAC and carotid wall areas to WMH and MoCA scores using Spearman correlation and multivariable linear and logistic regression models after adjusting for traditional risk factors, including age, ethnicity, male sex, diabetes mellitus, hypertension, smoking, and body mass index.

ICA and CCA wall areas correlated with WMH and MoCA score (all p<.001) in unadjusted models. After adjusting for traditional risk factors, ICA wall area remained associated with MoCA (β= -0.02, p<.05), and CCA wall area remained associated with WMH (β= 0.002, p=0.04). Increasing ICA wall area predicted MoCA score <26 (OR 1.12 per SD change, 95% CI 0.99-1.26, p=0.04) after multivariable adjustment, but increasing CCA wall area did not predict MoCA score <26 (p=0.5). After adjusting for traditional risk factors, CAC was associated with WMH (β= 0.013, p=0.0008). Increasing CAC score predicted large WMH (OR 1.19 per SD change, 95% CI 1.03-1.38, p=0.02).                  

Subclinical coronary and carotid atherosclerosis are predictors of poorer cognitive function as measured by MoCA score and white matter hyperintensity volume on MRI. 

Subclinical atherosclerosis may predict cognitive decline independent of traditional cardiovascular risk factors. Different sites and measures of atherosclerosis may have different sensitivities for predicting cognitive dysfunction..

Maroules, C, Berry, J, Khera, A, Rossetti, H, Carter, K, Gupta, M, Peshock, R, McColl, R, Ayers, C, Malguria, N, Abbara, S, King, K, Subclinical Atherosclerosis and Cognitive Impairment: The XXXXX Heart Study.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14009381.html