In an older-age vascular cohort, carotid stenosis is associated with processing speed and executive function cognitive deficits, which correlate with p-tau217

Summan Zahra, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Scott R. French, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Juan C. Arias, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Madeline Ally, Department of Psychology, University of Arizona, Tucson, Arizona, USA.
Haley Wiskoski, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Cris Escareno, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Emma Heitkamp, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Franchell Vazquez, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Madison Hillis, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Gavin Culwell, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Karthik Ainapurapu, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Caronae M. Howell, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Kevin Johnson, Department of Medical Imaging, University of Arizona, Tucson, Arizona, USA.
Deniz Karakay, Department of Electrical and Computer Engineering, University of Arizona, Tucson, Arizona, USA.
Karthik Rayasam, Department of Medical Imaging, University of Arizona, Tucson, Arizona, USA.
Lindsay Taylor, Department of Radiology, Creighton University School of Medicine, Phoenix Health Sciences, Phoenix, Arizona, USA.
Cody Kraemer, Pima Heart and Vascular, Tucson, Arizona, USA.
Luis Leon, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Scott Berman, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Federico Yanquez, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Joshua Balderman, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Joseph Sabat, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Olivia Hung, Department of Cardiovascular Medicine, Sarver Heart Center, University of Arizona College of Medicine, Tucson, Arizona, USA.
Layla Lucas, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Edward J. Bedrick, Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona Health Sciences, Tucson, Arizona, USA.
Francesca Vitali, Department of Neurology, University of Arizona, Tucson, Arizona, USA.
Raza Mushtaq, Department of Neuroradiology, Barrow Neurological Institute, Phoenix, Arizona, USA.
Maria Altbach, Department of Biomedical Engineering, University of Arizona, Tucson, Arizona, USA.
Theodore P. Trouard, Department of Biomedical Engineering, University of Arizona, Tucson, Arizona, USA.
Ali Bilgin, Department of Biomedical Engineering, University of Arizona, Tucson, Arizona, USA.
Eric M. Reiman, Banner Alzheimer's Institute, Phoenix, Arizona, USA.

Document Type

Article

Abstract

INTRODUCTION: Asymptomatic extracranial carotid atherosclerotic disease (aECAD) has been associated with Alzheimer's disease (AD), but the earliest cognitive deficits in this hallmark vascular population are largely unknown. METHODS: A total of 182 participants 50-85 years of age with ≥2 vascular comorbidities with/without aECAD were evaluated prospectively using a neurocognitive battery and compared to vascular comorbidities, percent stenosis, apolipoprotein E (APOE) ε4 status, and plasma phosphorylated tau (p-tau217). Dementia, stroke < 6 months, and neurological disorders were exclusionary. RESULTS: aECAD was associated with significantly worse scores in processing speed (β = -0.19, p = 0.004) and executive function (β = -0.20, p = 0.009) domains after controlling for age, sex, education, race, and ethnicity. From these, a carotid cognitive index was created, which correlated with p-tau217 (β = -0.29, p < 0.001), accounting for demographics, vascular comorbidities, white matter lesions, and APOE ε4 status. DISCUSSION: These data identify specific cognitive deficits associated with carotid stenosis and build further impetus to understand how vascular-related cognitive deficits contrast and complement the classic memory deficits of AD.

Medical Subject Headings

Humans; Male; Female; Aged; Executive Function (physiology); tau Proteins (blood); Carotid Stenosis (complications); Cognitive Dysfunction (etiology); Aged, 80 and over; Neuropsychological Tests (statistics & numerical data); Middle Aged; Cohort Studies; Prospective Studies; Phosphorylation; Processing Speed

Publication Date

11-1-2025

Publication Title

Alzheimer's & dementia : the journal of the Alzheimer's Association

E-ISSN

1552-5279

Volume

21

Issue

11

First Page

e70893

PubMed ID

41249770

Digital Object Identifier (DOI)

10.1002/alz.70893

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