Key result
Higher CCA and ICA end diastolic velocities linked to higher MoCA-FN scores.
Why the study?
Native American individuals have higher rates of cerebro-cardiovascular disease and dementia, and it was hypothesized that carotid and vertebral blood flow velocities could serve as surrogates for cerebral perfusion and correlate with cognitive performance.
Are carotid and vertebral artery blood flow velocities associated with cognitive function in a Native American population?
Are carotid and vertebral artery blood flow velocities associated with cognitive function in a Native American population?
While carotid end diastolic velocities initially correlated with cognitive scores, the association was not independent of traditional stroke risk factors in this Native American cohort.
End-diastolic carotid velocities associated with cognition but not independently; leaves open cerebrovascular contributions beyond traditional risks.
Introduction: Native American individuals are more frequently affected by cerebro-cardiovascular disease and its comorbidities, hypertension, hypercholesterolemia, diabetes, obesity, vascular brain injury, and dementias. Prevalence of Alzheimer disease and other dementias is increasing, with age being the primary risk factor. It is hypothesized that age-related changes in cardiovascular structure contribute to cognitive decline, and one proposed mechanism is reduced cerebral perfusion. We hypothesized that blood flow velocities in the common carotid artery (CCA), internal carotid artery (ICA), and vertebral arteries could be used as surrogates for cerebral perfusion and are associated with cognitive performance in our Wisconsin Native American population. Methods: 119 Native American individuals from the Oneida Nation tribe in Wisconsin enrolled in the “Stroke Prevention in the Wisconsin Native American Population” study and underwent a targeted health history, as well as blood work, clinical carotid ultrasound with B-mode, color Doppler and pulse wave Doppler, and cognitive testing using the Montreal Cognitive Assessment–First Nations (MoCA-FN). Results: Higher end diastolic velocities measured in the CCA and ICA were positively associated with higher scores on the MoCA-FN (r = 0.233, P = .012 and r = 0.198, P = .042, respectively). Distal CCA and ICA peak systolic velocities and ICA:CCA ratios were not found to correlate with cognitive performance nor did systolic or diastolic blood pressure (all P -values > .05). Associations between carotid end diastolic velocities and MoCA-FN were not statistically significant after adjustment for traditional stroke risk factors (age, gender, body mass index [BMI], systolic blood pressure, diastolic blood pressure, current smoking, physical activity, total cholesterol, low-density lipoprotein (LDL)-C, high-density lipoprotein (HDL)-C, and hemoglobin A1c), ( P > .05). The presence of plaque was also not associated with the MoCA-FN score ( P > .05). Conclusion: Future longitudinal studies are needed for this population that evaluate the composite of all risk factors and treatments targeting multiple risk factors at the same time.
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Cress et al. (2026) studied this question. Higher end diastolic velocities in the CCA and ICA were positively associated with MoCA-FN scores (r = 0.233, P = .012; r = 0.198, P = .042).
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