engleski

Mild cognitive impairment in asymptomatic patients with severe carotid stenosis or occlusion

Vascular risk factors have an important role not only in the in the development of stroke, but also of cognitive decline. Advanced stenosis or occlusion of the internal carotid artery (ICA s/o) is known to be associated with vascular risk but also with cognitive decline. We therefore evaluated cognitive functions in patients with vascular risk factors with and without advanced carotid disease. Cognitive status of 42 patients with vascular risk factors, diagnosed with mild cognitive impairment (MCI) and with advanced ICAs/o (PG) was compared with age and gender matched control group of 42 MCI patients with vascular risk but without ICAs/o (CG). Cognitive testing was performed using MMSE and Montreal Cognitive Assessment (MoCA). Cognitive performance on both tests and on cognitive domains covered by MoCA was correlated with vascular risk profile. Compared to MCI patients without concomitant advanced ICA s/o, MCI patients with ICA s/o scored significantly worse on MoCA (p=0, 049) and on the short-term memory domain MoCA subtest (p=0, 026). MMSE cognitive scores did not differ significantly between groups. Analysis of cognitive domains covered by MoCA in subgroups of participants with different vascular risk factors showed significant association of impaired attention with hypertension, diabetes, hyperlipidaemia, smoking and with multiple risk factors (>2). Diabetes was also significantly associated with the impaired language domain (p< 0, 05). Patients with vascular risk factors and concomitant advanced carotid disease seem to be at increased risk of developing cognitive decline. The pattern of cognitive impairment could be easily revealed when MoCA subtests scores are analysed.

vascular dementia; carotid artery; atherosclerosis

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