S. Claiborne Johnston, MD, PhD; Ellen S. O'Meara, PhD; Teri A. Manolio, MD, PhD; David Lefkowitz, MD; Daniel H. O'Leary, MD; Steven Goldstein, MD†; Michelle C. Carlson, PhD; Linda P. Fried, MD, MPH; W. T. Longstreth, MD, MPH
A full list of investigators and institutions that participated in the Cardiovascular Health Study can be found at http://www.chs-nhlbi.org.
Grant Support: The research reported in this article was supported by contracts N01-HC-85079 through N01-HC-85086, N01-HC-35129, and N01-HC-15103 from the National Heart, Lung, and Blood Institute. Dr. Johnston was supported by National Institute of Neurological Disorders and Stroke (grant no. NS02254).
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: S. Claiborne Johnston, MD, PhD, Department of Neurology, Box 0114, University of California, San Francisco, 505 Parnassus Avenue, M-798, San Francisco, CA 94143-0114.
Current Author Addresses: Dr. Johnston: Department of Neurology, Box 0114, University of California, San Francisco, 505 Parnassus Avenue, M-798, San Francisco, CA 94143-0114.
Dr. O'Meara: Department of Biostatistics, Box 354922, University of Washington, Seattle, WA 98115.
Dr. Manolio: National Lung, Heart and Blood Institute, National Institutes of Health, Two Rockledge Centre, 6701 Rockledge Drive, Room 8160, Mail Station 7934, Bethesda, MD 20892-7934.
Dr. Lefkowitz: Department of Neurology, Wake Forest University, Medical Center Boulevard, Winston-Salem, NC 27157.
Dr. O'Leary: Department of Radiology, Box 380, New England Medical Center, 750 Washington Street, Boston, MA 02111.
Drs. Carlson and Fried: Bloomberg School of Public Health, Johns Hopkins University, 2024 East Monument Street, Baltimore, MD 21205.
Dr. Longstreth: Department of Neurology, Box 359775, Harborview Medical Center, 325 9th Avenue, Seattle, WA 98104.
Author Contributions: Conception and design: S.C. Johnston.
Analysis and interpretation of the data: S.C. Johnston, E.S. O'Meara, D. Lefkowitz, D.H. O'Leary, M.C. Carlson, W.T. Longstreth.
Drafting of the article: S.C. Johnston.
Critical revision of the article for important intellectual content: T.A. Manolio, D. Lefkowitz, D.H. O'Leary, W.T. Longstreth.
Final approval of the article: S.C. Johnston, E.S. O'Meara, T.A. Manolio, D.H. O'Leary, M.C. Carlson, W.T. Longstreth.
Provision of study materials or patients: D.H. O'Leary, L.P. Fried.
Statistical expertise: S.C. Johnston, E.S. O'Meara.
Administrative, technical, or logistic support: S.C. Johnston, W.T. Longstreth.
Collection and assembly of data: D.H. O'Leary.
Johnston SC, O'Meara ES, Manolio TA, Lefkowitz D, O'Leary DH, Goldstein S, et al. Cognitive Impairment and Decline Are Associated with Carotid Artery Disease in Patients without Clinically Evident Cerebrovascular Disease. Ann Intern Med. 2004;140:237-247. doi: 10.7326/0003-4819-140-4-200402170-00005
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Published: Ann Intern Med. 2004;140(4):237-247.
While stroke is a known cause of cognitive impairment, the relationship between carotid artery stenosis and cognitive function in people without a history of stroke is unclear.
In this study of 4006 right-handed individuals 65 years of age and older, left-sided carotid artery stenosis of at least 75% was associated with cognitive impairment at baseline and cognitive decline over 5 years. This association persisted after right-sided carotid stenosis and cardiovascular risk factors were taken into account, which means that left-sided stenosis is more than simply an indicator of cardiovascular disease.
This observational study does not constitute evidence that treatment of left-sided stenosis would benefit cognition.
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