Intracranial arteriosclerosis and the risk of dementia: A population‐based cohort study

BACKGROUND The impact of intracranial arteriosclerosis on dementia remains largely unclear. METHODS In 2339 stroke‐free and dementia‐free participants (52.2% women, mean age 69.5 years) from the general population, we assessed intracranial carotid artery calcification (ICAC) and vertebrobasilar arte...

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Bibliographic Details
Published in:Alzheimer's & dementia 2024-02, Vol.20 (2), p.869-879
Main Authors: Beukel, Tim C., Wolters, Frank J., Siebert, Uwe, Spiering, Wilko, Ikram, M. Arfan, Vernooij, Meike W., Jong, Pim A., Bos, Daniel
Format: Article
Language:English
Subjects:
Aged
Alzheimer's disease
arterial calcification
Arteriosclerosis
Atherosclerosis
Brain research
Brain structure
Calcification
Carotid Artery Diseases - complications
Carotid Artery Diseases - epidemiology
Cohort analysis
Cohort Studies
cohort study
Dementia
Dementia - complications
Dementia - epidemiology
Disease
epidemiology
Etiology
Female
Histology
Humans
Indirect effects
Informed consent
Intracranial Arteriosclerosis - complications
Longitudinal studies
Magnetic resonance imaging
Male
Morphology
Reproducibility
Risk Factors
Stroke
Stroke - complications
Vascular Calcification - complications
Vascular Calcification - epidemiology
Veins & arteries
Women
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Summary:BACKGROUND The impact of intracranial arteriosclerosis on dementia remains largely unclear. METHODS In 2339 stroke‐free and dementia‐free participants (52.2% women, mean age 69.5 years) from the general population, we assessed intracranial carotid artery calcification (ICAC) and vertebrobasilar artery calcification (VBAC) as proxy for arteriosclerosis. Associations with dementia were assessed using Cox models. In addition, indirect effects through cerebral small vessel disease (cSVD) and subcortical brain structure volumes were assessed using causal mediation analyses. RESULTS During a median of 13.4 years (25th–75th percentiles 9.9–14.5) of follow‐up, 282 participants developed dementia. Both ICAC presence (hazard ratio [HR]: 1.53, 95% confidence interval [CI]: 1.00–2.32]) and volume (HR per standard deviation: 1.19, 95% CI: 1.01–1.40) increased dementia risk. For VBAC, severe calcifications increased dementia risk (HR for third vs first volume tertile: 1.89, 95% CI: 1.00–3.59). These effects were mediated partly through increased cSVD (percentage mediated for ICAC: 13% and VBAC: 24%). DISCUSSION Intracranial arteriosclerosis increases the risk of dementia.
ISSN:1552-5260
1552-5279
1552-5279
DOI:10.1002/alz.13496