Carotid circumferential wall stress is not associated with cognitive performance among individuals in late middle age: The Maastricht Study

Stefan L. C. Geijselaers*, Simone J. S. Sep, Miranda T. Schram, Martin P. J. van Boxtel, Thomas T. van Sloten, Jos op Het Roodt, Ronald M. A. Henry, Koen D. Reesink, Nicolaas C. Schaper, Pieter C. Dagnelie, Carla J. H. van der Kallen, Geert Jan Biessels, Coen D. A. Stehouwer

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background and aims: Arterial remodelling aims at normalising circumferential wall stress (CWS). Greater CWS in the carotid artery has previously been associated with the prevalence and severity of cerebral small vessel disease, a major cause of ageing-related cognitive decline. Here we test the hypothesis that greater carotid CWS is associated with poorer cognitive performance.

Methods: We studied 722 individuals (60 +/- 8 years, 55% men, 42.5% highly educated, blood pressure 137 +/- 19/77 +/- 11 mmHg, n = 197 with type 2 diabetes) who completed a neuropsychological assessment and underwent vascular ultrasound to measure the intima-media thickness (IMT) and interadventitial diameter (IAD) of the left common carotid artery at a plaque-free site. From IMT and IAD, lumen diameter (LD) was calculated. These structural measures were then combined with local carotid pulse pressure and brachial mean arterial pressure to obtain a measure of pulsatile (CWSpulsatile) and average (CWSmean) mechanical load on the vessel wall. Cognitive domains assessed were memory, executive function and attention, and processing speed.

Results: After adjustment for age, sex, and education, regression analyses showed that neither CWSpulsatile nor CWSmean were associated with measures of cognitive performance (p-values >= 0.31). This null association did not differ by age or educational level, and was observed in both individuals with and without carotid plaque, diabetes and/or hypertension. In addition, none of the individual measures of carotid structure (i.e. IMT, IAD, and LD) was related to cognitive performance.

Conclusions: The present cross-sectional study shows that carotid CWS is not associated with cognitive performance, at least not among relatively highly educated individuals in late middle age with adequately controlled cardiovascular risk factors. (c) 2018 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Original languageEnglish
Pages (from-to)15-22
Number of pages8
JournalAtherosclerosis
Volume276
DOIs
Publication statusPublished - Sept 2018

Keywords

  • INTIMA-MEDIA THICKNESS
  • SMALL-VESSEL DISEASE
  • HEALTH-PROMOTING PROGRAM
  • CARDIOVASCULAR-DISEASE
  • METABOLIC SYNDROME
  • SUBCLINICAL-ATHEROSCLEROSIS
  • ARTERY ATHEROSCLEROSIS
  • RISK-FACTORS
  • IMPAIRMENT
  • POPULATION

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