Association between Carotid Intima-Media Thickness and Cognitive Impairment in a Chinese Stroke Population: A Cross-sectional Study.

Cognitive impairment is associated with disability and care dependence worldwide. Cognitive impairment may be the earliest, most common, and subtlest manifestation of cerebrovascular disease1,2. Previous studies have suggested that silent stroke may occur concurrently with vascular risk factors3 and cause accumulated cognitive decline4. Western studies have investigated the association between vascular risk factors and cognitive impairment in elderly individuals5,6,7,8 and demonstrated that carotid atherosclerosis is a risk factor for cognitive impairment. Few studies have investigated the relationship between carotid atherosclerosis and cognitive impairment in younger adults9,10. Previous epidemiological studies have indicated an association between carotid atherosclerosis and cognitive decline in stroke-free individuals, but the results from population-based studies have been less consistent. Hachinski et al. reported that one sixth of all patients exhibit cognitive impairment prior to an acute stroke, and one third of all patients develop impairment after an acute stroke1. In addition, cerebral infarction contributes to cognitive impairment in approximately 50% of cases11 and is occasionally associated with Alzheimer’s disease12. Until now, limited studies have investigated the associations between carotid intima-media thickness (IMT) and cognitive impairment in stroke patients13,14. We therefore conducted this study to examine the relationship between IMT, stratified by max and mean value, and cognitive function in stroke individuals.