Carotid plaque score and internal carotid artery resistive index were independently associated with possible mild cognitive impairment in community-dwelling older Egyptian adults, with plaque burden most strongly linked to visuospatial and language performance.
Carotid plaques were detected in 53% of the study participants.
Sixty-one percent of participants were classified as having possible mild cognitive impairment (MCI) based on MoCA scores.
Carotid plaque score was independently associated with possible MCI in multivariable analysis.
Internal carotid artery resistive index (ICA RI) was independently associated with possible MCI in multivariable analysis.
Lower educational attainment showed the strongest association with possible MCI across both multivariable models.
Carotid plaque burden was most strongly associated with visuospatial and language cognitive domains specifically.
The study provides evidence supporting carotid ultrasound markers as potential predictors of cognitive decline in a non-Western population.
This research suggests that older adults who have more plaque buildup in their carotid arteries (the major blood vessels supplying the brain) and altered blood flow patterns in these arteries are more likely to show signs of cognitive impairment. The study followed 100 Egyptian adults aged 60 and older living in the community, using neck ultrasound to measure both plaque buildup and blood flow resistance, while also testing their thinking and memory abilities. About 61% of participants showed signs of possible mild cognitive impairment, and both higher plaque levels and higher blood flow resistance in the internal carotid artery were independently linked to this cognitive impairment, even after accounting for other factors. One notable finding is that the connection between carotid plaque and cognition was not uniform across all mental abilities — it was most pronounced in the areas of visuospatial skills (such as judging distances and spatial relationships) and language. This suggests that artery disease may affect certain brain regions or networks more than others. Interestingly, lower levels of education had an even stronger association with cognitive impairment than either of the artery measures, highlighting the important role of educational background in brain health. This research matters because it extends findings from Western populations to an Egyptian community sample, suggesting that carotid artery health and cognitive decline may be linked across different populations. Because this was a snapshot-in-time (cross-sectional) study, it cannot prove that artery disease causes cognitive decline, but the authors suggest that routine carotid ultrasound — a safe and relatively inexpensive test — might one day help identify people at risk for cognitive decline before symptoms become severe. Longitudinal studies tracking these individuals over time are needed to confirm whether these artery measurements can predict future cognitive decline.
Elhfnawy A, Kishk M, El Deeb H, Mekky J. (2026). Carotid plaque burden and hemodynamic alterations are associated with domain-specific cognitive impairment in community-dwelling older adults.. Scientific reports. https://doi.org/10.1038/s41598-026-66871-w