Research progress on carotid artery changes and cognitive impairment in Alzheimer's disease patients.

This article aims to comprehensively analyze the vascular factors in Alzheimer's Disease (AD), particularly the changes in the carotid arteries, and their complex correlations with hippocampal atrophy and cognitive function. Besides the traditional β-amyloid protein (Aβ) and Tau protein hypotheses, vascular factors are increasingly regarded as crucial factors in the development of AD. This article systematically reviews the roles of cerebral blood flow perfusion changes and micro-infarctions in the vascular pathophysiological processes during the progression of AD, and focuses on how thickening of the carotid intima-media thickness (IMT) and plaque formation in large vessels affect cerebral perfusion, thereby accelerating the deterioration of cognitive function (measured by the Montreal Cognitive Assessment (MoCA) score and the Mini-Mental State Examination (MMSE) score). Through the integration and analysis of existing literature and research data up to 2025, it is found that a large number of basic and clinical studies have confirmed the close connection between carotid artery changes and AD, but there is still a significant evidence gap regarding the association between carotid artery changes and the hippocampal region related to cognition.