The progression of carotid atherosclerosis and imaging markers of dementia

Introduction: We studied the association of carotid intima-media thickness (CIMT) with hippocampal volume (HV) in community dwelling individuals, testing the hypothesis that persons with carotid atherosclerosis progression would have lower HV. Methods: We studied 1376 Framingham Offspring participants with two carotid ultrasounds and brain magnetic resonance imaging (MRIs). We used multivariable linear regression analyses to relate CIMT progression and HV and total brain volume. Regression models were adjusted for demographics and vascular risk factors, time interval between imaging examinations, and baseline CIMT. We assessed effect modification by hypertension treatment (HRx). Results: Participants with higher ICA IMT progression had significantly lower HV after adjustment for vascular risk factors and baseline IMT (standardized beta ± standard error: −0.067 ± 0.027, P =.01). We observed weaker association between ICA IMT change and HV among subjects treated for hypertension (β = −0.047, P =.19 vs β = −0.096, P =.026). Discussion: Cumulative vascular risk factor exposure, reflected by CIMT progression, may increase the risk of neurodegeneration.