Cognitive trajectories and incident dementia after a cardiovascular event in older adults

Author:

Vishwanath Swarna1ORCID,Hopper Ingrid1,Wolfe Rory1,Polekhina Galina1,Reid Christopher M.12,Tonkin Andrew M.1,Murray Anne M.34,Shah Raj C.5,Storey Elsdon1,Woods Robyn L.1,McNeil John1,Orchard Suzanne G.1,Nelson Mark R.16,Steves Claire J.7,Ryan Joanne1

Affiliation:

1. School of Public Health and Preventive Medicine Monash University Victoria Australia

2. School of Public Health Curtin University Bentley Western Australia Australia

3. Berman Center for Outcomes & Clinical Research Hennepin Healthcare Research Institute Minneapolis Minnesota USA

4. Department of Medicine Division of Geriatrics Hennepin Healthcare University of Minnesota Minneapolis Minnesota USA

5. Department of Family Medicine and the Rush Alzheimer's Disease Centre Rush University Medical Centre Chicago Illinois USA

6. Menzies Institute for Medical Research University of Tasmania Hobart Australia

7. Department of Twin Research & Genetic Epidemiology King's College London London UK

Abstract

AbstractINTRODUCTIONCardiovascular disease (CVD) is a recognized risk factor for dementia. Here we determined the extent to which an incident CVD event modifies the trajectory of cognitive function and risk of dementia.METHODS19,114 adults (65+) without CVD or dementia were followed prospectively over 9 years. Incident CVD (fatal coronary heart disease, nonfatal myocardial infarction [MI], stroke, hospitalization for heart failure) and dementia (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria) were adjudicated by experts.RESULTSNine hundred twenty‐two participants had incident CVD, and 44 developed dementia after CVD (4.9% vs. 4.4% for participants without CVD). Following a CVD event there was a short‐term drop in processing speed (−1.97, 95% confidence interval [CI]: −2.57 to −1.41), but there was no significant association with longer‐term processing speed. In contrast, faster declines in trajectories of global function (−0.56, 95% CI: −0.76 to −0.36), episodic memory (−0.10, 95% CI: −0.16 to −0.04), and verbal fluency (−0.19, 95% CI: −0.30 to −0.01) were observed.DISCUSSIONFindings highlight the importance of monitoring cognition after a CVD event.

Funder

National Institutes of Health

Publisher

Wiley

Subject

Psychiatry and Mental health,Cellular and Molecular Neuroscience,Geriatrics and Gerontology,Neurology (clinical),Developmental Neuroscience,Health Policy,Epidemiology

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