Cardiac disease associated with increased risk of nonamnestic cognitive impairment

Document Type

Article

Abstract

Objective: To investigate the association of cardiac disease with amnestic and nonamnestic mild cognitive impairment (aMCI and naMCI, respectively). Nonamnestic mild cognitive impairment, a putative precursor of vascular and other non-Alzheimer dementias, is hypothesized to have a vascular etiology. Design: A prospective, population-based, cohort study with a median 4.0 years of follow-up. Setting: Olmsted County, Minnesota. Participants: A total of 2719 participants were evaluated at baseline and every 15 months using the Clinical Dementia Rating scale, a neurological evaluation, and neuropsychological testing. A diagnosis of normal cognition, MCI, or dementia was made by consensus. Cardiac disease at baseline was assessed from the participant's medical records. Main Outcome Measures: Incident MCI, aMCI, or naMCI. Results: Of 1450 participants without MCI or dementia at baseline, 366 developed MCI. Cardiac disease was associated with an increased risk of naMCI (hazard ratio, 1.77 [95% CI, 1.16-2.72]). However, the association varied by sex (P=.02 for interaction). Cardiac disease was associated with an increased risk of naMCI (hazard ratio, 3.07 [95% CI, 1.58-5.99]) for women but not for men (hazard ratio, 1.16 [95% CI, 0.68-1.99]). Cardiac disease was not associated with any type of MCI or with aMCI. Conclusions: Cardiac disease is an independent risk factor for naMCI; within-sex comparisons showed a stronger association for women. Prevention and management of cardiac disease and vascular risk factors may reduce the risk of naMCI. © 2013 American Medical Association. All rights reserved.

Publication Date

1-1-2013

Publication Title

JAMA Neurology

ISSN

21686149

Volume

70

Issue

3

First Page

374

Last Page

382

Digital Object Identifier (DOI)

10.1001/jamaneurol.2013.607

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