Affiliation:
1. Department of Neurology, Hennepin Healthcare Research Institute Hennepin County Medical Center Minneapolis MN
2. Division of Epidemiology and Community Health, School of Public Health University of Minnesota Minneapolis MN
3. Faculty of Science University of British Columbia Vancouver British Columbia Canada
4. Clinical Neurology Research Center Shiraz University of Medical Sciences Shiraz Iran
5. HealthPartners Institute Minneapolis MN
6. Berman Center for Outcomes and Clinical Research and Geriatrics Division, Department of Medicine Hennepin Healthcare Research Institute Minneapolis MN
Abstract
Background
Intracranial atherosclerosis disease (ICAD) alters cerebrovascular hemodynamics and brain structural integrity. Multiple studies have evaluated the link between ICAD and cognitive impairment, with mixed results. This study aims to systematically review and summarize the current evidence on this link.
Methods and Results
PubMed, EMBASE, PsycInfo, and Web of Science were searched from 2000 to 2023 without language restriction. Cross‐sectional and prospective cohort studies as well as postmortem studies were included. Studies containing data on the link between ICAD, defined as at least 50% stenosis in 1 intracranial vessel, and cognitive impairment and dementia were screened by 2 independent reviewers. A total of 22 (17 observational and 5 postmortem) unique studies, comprising 11 184 individuals (average age range, 59.8–87.6 years; 45.7% women; 36.5% Asian race), were included in the systematic review. Seven of 10 cross‐sectional studies and 5 of 7 prospective studies showed a significant association between ICAD and cognitive impairment. In the pooled analysis, ICAD was associated with greater cognitive impairment (measure of association, 1.87 [95% CI, 1.49–2.35]). Meta‐regression analyses did not show a significant impact of age, sex, and race. All postmortem studies showed that patients with Alzheimer disease and vascular dementia had a higher burden of ICAD compared with controls.
Conclusions
This study shows that ICAD is associated with cognitive impairment and dementia across age, sex, and race groups. Our findings may underscore the need to develop individualized dementia preventive care plans in patients with ICAD.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Cited by
4 articles.
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