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Carotid endarterectomy mitigates Alzheimer's disease and non–Alzheimer's disease dementia risk linked to asymptomatic carotid stenosis

Year: 2025

Type: article

Abstract: INTRODUCTION: Asymptomatic extracranial carotid artery disease (aECAD) is associated with increased Alzheimer's disease (AD) and non-AD dementia risk. aECAD treatment includes carotid endarterectomy (CEA) and carotid artery stenting (CAS) for stroke prevention, but their impact on dementia incidence is poorly studied. METHODS: Propensity score matching was used in a retrospective cohort study of United States-based insurance claims (2010-2022) in 487,676 patients with aECAD to evaluate the effect of CEA and CAS on AD and non-AD dementia incidence. RESULTS: After matching, 37,317 patients underwent CEA or CAS. CEA was associated with a significantly lower AD risk (relative risk = 0.93; 95% confidence interval, 0.86-0.99; P < 0.05), whereas CAS was associated with a slight but non-significant increase. Similar trends were observed for non-AD dementia. DISCUSSION: CEA, but not CAS, may confer a protective effect against AD and non-AD dementia in patients with aECAD, a common cerebrovascular disease affecting up to 15% of adults over age 60. HIGHLIGHTS: Asymptomatic extracranial carotid artery disease (aECAD) is associated with increased Alzheimer's disease (AD) and non-AD dementia risk. Limited studies have evaluated the role of carotid endarterectomy (CEA) and (carotid artery stenting (CAS) on dementia outcomes. Using United States-based insurance claims data, 487,676 patients with aECAD were evaluated. After propensity score matching, CEA was significantly associated with reduced AD risk. CAS was not significantly associated with a change in AD risk.

Source: Alzheimer s & Dementia

DOI: 10.1002/alz.70674