Heart Disease, Cognitive Decline Linked in Women
Key points
- Heart disease in older women tripled their likelihood of mild cognitive impairment, data from a large cohort study showed.
- The association between heart disease and cognitive function was limited to the non-amnestic subtype of impairment, which involves cognitive domains other than memory.
- In contrast, men with cardiac disease had a nonsignificant 1.16 hazard ratio compared with men who did not have cardiac disease (95% CI 0.68 to 1.99), they reported online in JAMA Neurology.
- Men with heart disease also had an increased risk of mild cognitive impairment, but the association did not achieve statistical significance, the investigators found.
Heart disease in older women tripled their likelihood of mild cognitive impairment, data from a large cohort study showed.
The association between heart disease and cognitive function was limited to the non-amnestic subtype of impairment, which involves cognitive domains other than memory. Among women with cardiac disease, the hazard ratio for non-amnestic mild cognitive impairment was 3.07 versus women without cardiac disease (95% CI, 1.58 to 5.99), according to Rosebud Roberts, MB, ChB, of the Mayo Clinic in Rochester, Minn., and co-authors.
In contrast, men with cardiac disease had a nonsignificant 1.16 hazard ratio compared with men who did not have cardiac disease (95% CI 0.68 to 1.99), they reported online in JAMA Neurology.
Men with heart disease also had an increased risk of mild cognitive impairment, but the association did not achieve statistical significance, the investigators found.
"Our findings support the hypothesis that non-amnestic mild cognitive impairment has a vascular etiology," they wrote. "For women, the association of cardiac disease with non-amnestic mild cognitive impairment persisted after the exclusion of participants with a history of stroke and after adjustment for several confounders.
"The similar incidences of non-amnestic mild cognitive impairment for men with and without cardiac disease ... suggest that factors besides cardiac disease (e.g., stroke) may account for this higher incidence in men without cardiac disease."
After excluding participants with a history of stroke, the association between heart disease and non-amnestic mild cognitive impairment was no longer significant, suggesting stroke has a confounding effect, the researchers added.
Mild cognitive impairment represents a key diagnostic/prognostic threshold for dementia. Impairment associated with memory loss (amnestic) has been hypothesized as having a predilection toward progression to Alzheimer's disease.
In contrast, non-amnestic mild cognitive impairment may preferentially progress to vascular and other types of dementia unrelated to Alzheimer's disease, according to the authors' background information.
Roberts and colleagues previously reported a cross-sectional association between coronary disease and mild cognitive impairment (Neurobiol Aging 2010; 31: 1894-1902). They extended the investigation with separate analyses of the association in men and women.
The study population comprised 2,719 adults 70 and older participating in a prospective cohort study. Each participant underwent an evaluation at baseline and every 15 months thereafter by means of the Clinical Dementia Rating Scale. After each evaluation, investigators reached a consensus diagnosis of normal cognition, mild cognitive impairment, or dementia.
Cardiac disease was determined by review of participants' medical records.
Written and revised by
Andrey Nailor, M.D.
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