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Aterosclerosi subclinica e rischio di deterioramento cognitivo

Numerosi sono gli studi che hanno documentato una relazione tra fattori di rischio vascolare e disfunzione cognitiva. L'obiettivo dello studio di Rossetti e Coll è stato quello di verificare se l'aterosclerosi subclinica fosse in grado di predire l'evoluzione delle funzioni cognitive. Sono stati valutati il calcio coronarico, le placche e lo spessore dell'aorta addominale, tutti elementi che si sono dimostrati predittivi di futuri eventi cardiovascolari, in oltre 1.900 pazienti con età media di 42.9 anni. Dopo 8 anni, ai pazienti è stato somministrato un test per la valutazione delle capacità cognitive, ma non è emersa una chiara associazione tra la presenza di aterosclerosi subclinica ed il decadimento cognitivo.

Subclinical atherosclerosis and subsequent cognitive function.

Rossetti HC, Weiner M, Hynan LS, Cullum CM, Khera A, Lacritz LH

Atherosclerosis 2015;241:36-41

OBJECTIVE: To examine the relationship between measures of subclinical atherosclerosis and subsequent cognitive function.
METHOD: Participants from the Dallas Heart Study (DHS), a population-based multiethnic study of cardiovascular disease pathogenesis, were re-examined 8 years later (DHS-2) with the Montreal Cognitive Assessment (MoCA); N = 1904, mean age = 42.9, range 8-65. Associations of baseline measures of subclinical atherosclerosis (coronary artery calcium, abdominal aortic plaque, and abdominal aortic wall thickness) with MoCA scores measured at follow-up were examined in the group as a whole and in relation to age and ApoE4 status.
RESULTS: A significant linear trend of successively lower MoCA scores with increasing numbers of atherosclerotic indicators was observed (F(3, 1150) = 5.918, p = .001). CAC was weakly correlated with MoCA scores (p = .047) and MoCA scores were significantly different between participants with and without CAC (M = 22.35 vs 23.69, p = 0.038). With the exception of a small association between abdominal AWT and MoCA in subjects over age 50, abdominal AWT and abdominal aortic plaque did not correlate with MoCA total score (p = .052). Cognitive scores and atherosclerosis measures were not impacted by ApoE4 status (p = .455).
CONCLUSION: In this ethnically diverse population-based sample, subclinical atherosclerosis was minimally associated with later cognitive function in middle-aged adults.

Atherosclerosis 2015;241:36-41