Clogged Arteries Can Cause Mental Decline

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Clogged Arteries Can Cause Mental Decline

Mon Feb 16,11:47 PM ET

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By Steven Reinberg

HealthDay Reporter

MONDAY, Feb. 16 (HealthDayNews) -- Elderly people whose arteries that feed blood

to the brain are blocked face a higher risk not only of stroke, but an inability

to think clearly, a new study says.

 

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These large vessels on either side of the neck, called carotid arteries, can

become blocked over time as plaque builds up on the artery walls, narrowing the

vessels and restricting blood flow. As blood flow in the vessel is slowed, clots

can occur. These clots, when pushed though the artery, can block smaller

arteries in the brain, causing a stroke.

 

 

" But blockages in the carotid arteries are also associated with having trouble

with thinking, " says lead researcher Dr. S. Claiborne Johnston, an associate

professor of neurology and epidemiology at the University of California at San

Francisco.

 

 

Johnston's research team looked at 4,006 men and women aged 65 and older who

were included in the Cardiovascular Health Study. None of these people had had a

stroke or a transient ischemic attack (TIA). A TIA is a small stroke that

usually lasts for a few minutes, leaving no apparent damage.

 

 

The researchers used ultrasound to determine the condition of each patient's

left carotid artery.

 

 

They also had the subjects take a test, called the Modified Mini-Mental State

Examination, which evaluated their cognitive status. The test was repeated

annually for up to five years, according to their report in the Feb. 17 issue of

the Annals of Internal Medicine.

 

 

His team found that, when compared to people with normal carotid arteries, the

32 volunteers who had a severely narrowed neck vessel had significant cognitive

decline.

 

 

" We don't know why this happens, " Johnston says. " The presumption is either that

it causes very tiny strokes that are below our ability to detect, or that it

happens due to reduced blood flow to the brain. "

 

 

Johnston believes a series of small, undetectable strokes are the cause. " These

patients are already at risk for a major stroke, and this suggests that they are

also at risk for having trouble with thinking, " he adds.

 

 

In addition, Johnston says the decline in thinking caused by these tiny strokes

can lead to dementia.

 

 

Carotid disease may be causing other problems besides stroke and TIA, and

doctors and patients need to be aware of that and look for treatments to see if

the risk can be reduced without causing other problems, Johnston says.

 

 

" The problem right now is that we don't have the data which tells us whether the

surgery would eliminate the risk of cognitive decline. We also don't know if the

surgery could cause little strokes that cause cognitive decline, " Johnston says.

 

 

Dr. Henry J.M. Barnett, professor emeritus of medicine at the University of

Western Ontario, says that while this study adds knowledge, it fails to show how

this cognitive decline affects patients' daily lives.

 

 

In his editorial in the same journal issue, he also notes that collateral

circulation, which creates new blood vessels to compensate for small vessels

that are blocked, may prevent both stroke and cognitive decline.

 

 

Barnett goes on to say the reason for cognitive decline seen in some patients

might be due to other factors, such as a brain tumor, vitamin B12 deficiency, or

disease of the small arteries in the brain.

 

 

Moreover, he is afraid these findings may promote carotid endarterectomies

solely to prevent cognitive decline. A carotid endarterectomy is a high-risk

operation that carries with it the risk of stroke and death, he says.

 

 

More information

 

For more dementia, try the American Academy of Family Physicians or the National

Institute on Aging.

 

Find out the risk factors for stroke from the American Stroke Association.

 

 

 

 

 

 

 

 

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