Volume 49, Issue 4 Winter 2025 JVU 494-200 | Carotid and Vertebral Flow Velocities: Relationships with Cognitive Function in Wisconsin Native American Population-Carotid and Vertebral Flow Velocities: Relationships with Cognitive Function in Wisconsin Native American Population

Carotid and Vertebral Flow Velocities: Relationships with Cognitive Function in Wisconsin Native American Population

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This original research article examines whether blood flow velocities measured by ultrasound in carotid and vertebral arteries correlate with cognitive function in a Wisconsin Native American population known to have high cerebro-cardiovascular disease risk. The study analyzed 119 participants aged 54 and older from the Oneida Nation tribe. They underwent clinical carotid ultrasound (measuring peak systolic velocity and end diastolic velocity in common carotid artery [CCA], internal carotid artery [ICA], and vertebral arteries) and cognitive testing with the culturally adapted Montreal Cognitive Assessment–First Nations (MoCA-FN).<br /><br />In univariate analyses, higher end diastolic velocities (EDV) in the CCA and ICA were positively associated with better MoCA-FN cognitive scores (r = 0.233 and 0.198, p < 0.05). However, when controlling for age, sex, body mass index, blood pressure, smoking, physical activity, cholesterol levels, and hemoglobin A1c in regression models, these vascular velocity measures no longer significantly predicted cognitive performance. Age was consistently associated with lower cognitive scores, while female sex predicted higher scores. Presence of carotid plaque was not related to cognition. Surprisingly, blood pressure and other single stroke risk factors did not show association with cognition in this sample, possibly due to the high prevalence of hypertension and multiple comorbidities among participants (91% were high risk with ≥3 stroke risk factors).<br /><br />The study provides important data from a Native American community disproportionately affected by vascular disease and dementia but underrepresented in research. The authors highlight that cognitive impairment likely results from a complex interplay of many factors rather than any single vascular parameter alone. They advocate for longitudinal studies using a multimodal approach to assess combined risk factors and targeted interventions to reduce dementia risk in this vulnerable population. Limitations include a relatively small, single-population sample and use of a screening cognitive test; findings may not extrapolate broadly.<br /><br />In summary, although carotid and vertebral end diastolic flow velocities showed some correlation with cognition initially, after adjusting for confounders they were not independent predictors of MoCA-FN scores. Aging and sex were the strongest determinants. These findings stress the complexity of vascular contributions to cognitive decline in Native American elders and the need for integrated risk factor management strategies.

Keywords

blood flow velocities

carotid artery

vertebral artery

cognitive function

Wisconsin Native American

Oneida Nation tribe

Montreal Cognitive Assessment–First Nations (MoCA-FN)

end diastolic velocity

vascular disease

cognitive impairment