Background: The relation between atherosclerosis and brain atrophy remains unclear in patients with risk factors for cardiovascular diseases. Objective: This study was performed to clarify the relation between brain atrophy and carotid atherosclerosis. Methods: A total of 142 patients (78 women and 64 men, mean age 74 years) with no neurologic disturbances were studied. Brain atrophy was evaluated on the basis of the brain atrophy index (BAI, BAI = brain parenchyma/intracranial space A 100%), calculated by means of digitized computed tomographic scans obtained at the level of the basal ganglia. Carotid atherosclerosis was evaluated on the basis of the plaque score (PS), defined as the sum of all plaque heights in both carotid arteries, intima-media thickness (IMT), and vessel diameter (VD) of the common carotid artery as assessed by ultrasonography. Results: Age negatively correlated with BAI in both men (r = –0.587, p < 0.001) and women (r = –0.724, p < 0.001). PS of the carotid artery also negatively correlated with BAI in men (r = –0.502, p < 0.001) as well as women (r = –0.480, p < 0.001). VD and IMT of the right carotid artery negatively correlated with BAI in women (VD; –0.256, p < 0.05, IMT; –0.216, p < 0.05) but not in men. Other characteristics were unrelated to BAI. Multiple regression analysis showed that age and PS were independent predictors of brain atrophy in both sexes. The percentage of variance of BAI values explained by this model in women (51.9%) was much greater than that in men (35.5%). Conclusion: Carotid atherosclerosis may be a useful morphological index of brain atrophy.

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