Cardiac disease associated with increased risk of nonamnestic cognitive impairment: stronger effect on women

JAMA Neurol. 2013 Mar 1;70(3):374-82. doi: 10.1001/jamaneurol.2013.607.

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.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Amnesia*
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / epidemiology*
  • Cognition Disorders / psychology
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Heart Diseases / diagnosis*
  • Heart Diseases / epidemiology*
  • Heart Diseases / psychology
  • Humans
  • Longitudinal Studies
  • Male
  • Population Surveillance / methods
  • Prospective Studies
  • Risk Factors
  • Sex Factors