Cardiac disease associated with increased risk of nonamnestic cognitive impairment

Rosebud O Roberts, Yonas Endale Geda, David S Knopman, Ruth H. Cha, V. Shane Pankratz, Bradley F Boeve, Eric George Tangalos, Robert J. Ivnik, Michelle M Mielke, Ronald Carl Petersen

Research output: Contribution to journalArticle

41 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)374-382
Number of pages9
JournalJAMA Neurology
Volume70
Issue number3
DOIs
StatePublished - Mar 2013

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Heart Diseases
Dementia
Vascular Dementia
Cognitive Dysfunction
Cognitive Impairment
Cognition
Medical Records
Blood Vessels
Consensus
Cohort Studies
Outcome Assessment (Health Care)
Population
Hazard

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Clinical Neurology

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Cardiac disease associated with increased risk of nonamnestic cognitive impairment. / Roberts, Rosebud O; Geda, Yonas Endale; Knopman, David S; Cha, Ruth H.; Pankratz, V. Shane; Boeve, Bradley F; Tangalos, Eric George; Ivnik, Robert J.; Mielke, Michelle M; Petersen, Ronald Carl.

In: JAMA Neurology, Vol. 70, No. 3, 03.2013, p. 374-382.

Research output: Contribution to journalArticle

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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.",
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AU - Cha, Ruth H.

AU - Pankratz, V. Shane

AU - Boeve, Bradley F

AU - Tangalos, Eric George

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AU - Petersen, Ronald Carl

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AB - 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.

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