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

TC van den Beukel, FJ Wolters, U Siebert, W Spiering, MA Ikram, MW Vernooij, PA de Jong, D Bos*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

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.
Original languageEnglish
Pages (from-to)869-879
Number of pages11
JournalAlzheimers & Dementia
Volume20
Issue number2
Early online date9 Oct 2023
DOIs
Publication statusPublished - Feb 2024

Bibliographical note

Publisher Copyright:
© 2023 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.

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