Table 3.
Association of intima-media thickness with cognition and dementia in prospective cohort studies.
| Study Name, Place and Year Published | Number and Age (Range or Mean) | Follow-up (Year) | Cognition Assessed |
Major Adjusted
Co-variates |
Main Results | Ref. |
|---|---|---|---|---|---|---|
| ARIC US 2001 |
10,963 (47-70) |
6 | Changes in DWR, DSS, and WF | Tertile of IMT had no significant association with changes in cognition. | [200] | |
| CHS US 2005 |
3,602 (74) |
5.4 | Incident dementia (total dementia, Alzheimer’s Disease with or without vascular dementia, and pure Alzheimer’s Disease | Age, race, education, hypertension, diabetes, smoking, income, ApoE, and MMSE | Adjusted hazard ratios (95% CI) of total dementia, Alzheimer’s disease with and without vascular dementia and pure Alzheimer’s disease in the 4th compared to 1st quartile of IMT were 1.6 (1.1-2.2), 1.4 (1.0-2.0), and 1.5 (1.0-2.2). | [190] |
| Rotterdam Study Netherlands 2007 |
6,647 (65.7 ± 6.9) |
9 | Incident dementia (total dementia, Alzheimer’s disease and vascular dementia) | Age, sex, education, BMI, blood pressure, total cholesterol, HDL-C and ApoE | Hazard ratios (95% CI) of dementia, Alzheimer’s disease and vascular dementia of 5th compared to 1st quintile of IMT were 1.50 (1.06-2.12), 1.54 (1.03-2.30) and 1.33 (0.47-3.75) | [191] |
| BLSA US 2009 |
538 (55) |
4 | I-M-C, MMSE, CVLT, BVRT, RCFT, TMT-A, TMT-B, Letter Fluency and Category Fluency | Age, sex, race, education, blood pressure, BMI, total cholesterol, and smoking | Regression coefficients in mixed-effects models associated with IMT were statistically significant for immediate free recall, short-delay free recall, and long-delay free recall in CVLT and long-delay recall in RCFT | [192] |
| Framingham Offspring Study US 2009 |
1,975 (58) | Base-line 1995-98, follow-up 1999-2001 | Classified into 3 factors: verbal memory, executive function and non-verbal memory factors | Age, sex, hypertension, smoking, diabetes, blood pressure, and cardiovascular disease | IMT had significant associations with executive and non-verbal memory factors. | [193] |
| ARIC MRI Study US 2009 |
1,130 (59 ± 4) |
14 | Changes in DWR, DSS, and WF | Age, sex, race, education, diabetes, ApoE | IMT had no significant association with changes in cognition. | [201] |
| INVADE Germany 2010 |
3,367 (67.7) | 2 | 6CIT Incident cognitive impairment was defined as a 6CIT score >7. |
Age, sex, hypertension, education, depression, physical activity baseline 6CIT score and geriatric depression scale | Multivariable-adjusted odd ratio of IMT ≥ 1.0 mm associated with incident cognitive impairment was 1.75 (95%CI: 1.15,2.59) | [194] |
| Tromso Study Norway 2012 |
4,371 (58.6 ± 9.3 for men and 59.5 ± 9.9 for women) | 7 | Verbal memory test, DSST and tapping test | Age, sex, education, physical activity, smoking, blood pressure, total cholesterol, HDL cholesterol, BMI, diabetes, coronary heart disease and depression | IMT has a significant association with DSST but not verbal memory or tapping tests. | [195] |
| EHLS US 2012 |
1,311 (66.8) |
10 | MMSE at baseline and follow-up. TMT-A, TMT-B, DSST, Rey AVLT and VFT at follow-up only | Age, sex, education, hypertension, hemoglobin A1c, HDL-C, history of cardiovascular disease, self-reported lifestyle factors | Multivariable-adjusted hazard ratio of 0.1 mm increase in IMT associated with incident cognitive impairment was 1.09 (95% CI: 1.01-1.18) IMT had a significant positive association with TMT-B but not with TMT-A, DSST, Rey ALVT or VFT |
[196] |
| KLoSHA South Korea 2015 |
348 (72 ± 6) |
5 | Korean versions of the Consortium to Establish a Registry for Alzheimer’s Disease Clinical Assessment Battery and the Mini International Neuropsychiatric Interview. | Age, education, hypertension, baseline MMSE, GDS-K, and CIRS | Multivariable-adjusted hazard ratio of IMT associated with progression of cognitive dysfunction was 1.251 (95%CI: 1.006-1.555) | [197] |
| CARDIA US 2015 |
2,618 (45.3 ± 3.6) |
5 | Rey AVLT, DSST, Stroop test | Age, sex, race, education, smoking, physical activity, BMI, diabetes, hypertension, glomerular filtration rate | 1 SD increase in IMT had significant associations with DSST and Stroop test | [198] |
ARIC: Atherosclerosis Risk in Communities, CHS: Cardiovascular Health Study, BLSA: Baltimore Longitudinal Study of Aging, INVADE: Intervention project on cerebrovascular diseases and dementia in the district of Ebersberg, Bavaria, EHLS: Epidemiology of Hearing Loss Study, KLoSHA: Korean Longitudinal study of health and aging, CARDIA: Coronary Artery Risk Development in Young Adults, DWR: Delayed word recall, DSS: Digit symbol subtest of the Wechsler Adult Intelligence Scale-Revised, WF: The first-letter word fluency, I-M-C: Information-Memory-Concentration test, MMSE: Mini-Mental State Examination, CVLT: California Verbal Learning Test, BVRT: Benton Visual Retention Test, RCFT: Rey Complex Figure Test, TMT-A: Trail-Making test A, TMT-B: Trail-Making Test B, DSST: digit symbol substitution test, 6CIT: 6 Item Cognitive Impairment Test, Rey AVLT: Rey Auditory Verbal Learning Test, VFT: Verbal Fluency test, ApoE: Apolipoprotein E genotype, BMI: Body-mass index, HDL-C: high-density lipoprotein cholesterol, GDS-K: Korean version of geriatric depression scale, CIRS: Cumulative illness rating scale.