Background: Longitudinal data on the role of atherosclerosis in different vessel beds in the etiology of cognitive impairment and dementia are scarce and inconsistent. Methods: Between 2003-2006, 2364 nondemented persons underwent computed tomography of the coronaries, aortic arch, extracranial, and intracranial carotid arteries to quantify atherosclerotic calcification. Participants were followed for incident dementia (n = 90) until April 2012. At baseline and follow-up participants also underwent a cognitive test battery. Results: Larger calcification volume in all vessels, except in the coronaries, was associated with a higher risk of dementia. After adjustment for relevant confounders, extracranial carotid artery calcification remained significantly associated with a higher risk of dementia [hazard ratio per standard deviation increase in calcification volume: 1.37 (1.05, 1.79)]. Additional analyses for Alzheimer's disease only or censoring for stroke showed similar results. Larger calcification volumes were also associated with cognitive decline. Conclusions: Atherosclerosis, in particular in the extracranial carotid arteries, is related to a higher risk of dementia and cognitive decline.

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Keywords Arterial calcification, Atherosclerosis, Cognitive decline, Dementia, Epidemiology, Imaging
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Journal Alzheimer's & Dementia
Bos, D, Vernooij, M.W, de Bruijn, R.F.A.G, Koudstaal, P.J, Hofman, A, Franco, O.H, … Ikram, M.A. (2015). Atherosclerotic calcification is related to a higher risk of dementia and cognitive decline. Alzheimer's & Dementia, 11(6), 639–647.e1. doi:10.1016/j.jalz.2014.05.1758