Cognitive impairment linked to carotid atherosclerosis in the very old

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  • Carotid atherosclerosis is consistently linked to cognitive impairment in the very old and affects the association with latent cytomegalovirus infection (CMV) infection.


Study design/methods

  • In the Tokyo Oldest Old Survey on Total Health, 494 community-dwelling participants >85 years  without baseline dementia underwent Mini-Mental State Examination (MMSE) and other testing at baseline and 3-year follow-up.


Key Results

  • Mean MMSE scores were 1.08 points lower in persons with high carotid artery ultrasound plaque score (≥5.0) than in those without plaque (95%CI -1.95 to -0.20; P=.016), adjusted for age, sex, and education.
  • MMSE scores were 1.47 points lower In persons with CMV IgG titers in the highest vs. lowest quartile (-2.44 to -0.50; P=.003).
  • CMV interacted with carotid atherosclerosis, but CMV was associated with MMSE only in persons with plaque.
  • After adjustment for age, sex, education, and baseline cognitiion, predictors of faster cognitive decline were atherosclerosis, smoking, low grip strength, and poor activities of daily living.



  • Findings might not apply to non-Japanese populations.


Why this matters

  • The effect of carotid atherosclerosis on the association of cognitive impairment with latent CMV infection suggests possible interventions.