Intracranial atherosclerosis disease linked to cognitive impairment, dementia

Individuals with intracranial atherosclerosis disease (ICAD) have a heightened risk of cognitive impairment and dementia, according to the results of a systematic review and meta-analysis.

Researchers searched multiple online databases for cross‐sectional and prospective cohort studies, as well as postmortem studies, in which the relationship between ICAD and cognitive impairment was examined. The studies had to have defined at least 50-percent stenosis in one intracranial vessel.

A total of 22 unique studies met the eligibility criteria and were included in the systematic review. Of the studies, 17 were observational and five were postmortem. The entire population comprised 11,184 individuals (average age range, 59.8–87.6 years; women, 45.7 percent; Asian, 36.5 percent).

ICAD was significantly associated with cognitive impairment and dementia in seven out of 10 cross‐sectional studies and five out of seven prospective studies. The pooled analysis also showed that ICAD was associated with greater cognitive impairment (measure of association, 1.87; 95 percent confidence interval, 1.49–2.35). Meta‐regression analyses did not show a significant impact of age, sex, and race.

All postmortem studies showed that the burden of ICAD had been higher in patients with Alzheimer’s disease and vascular dementia than in individuals without the neurodegenerative diseases.

The findings highlight the need to develop individualized dementia preventive care plans in patients with ICAD.