Elevated Natriuretic Peptide Levels and Cognitive Function in Community-dwelling Older Adults - 19/08/11
, Gail A. Laughlin, PhD b, Donna Kritz-Silverstein, PhD b, Paul Clopton, MS a, c, Wei-Chung Chen a, Alan S. Maisel, MD a, c, Elizabeth Barrett-Connor, MD b
Requests for reprints should be addressed to Lori B. Daniels, MD, MAS, FACC, Mail Code 0607, 9500 Gilman Dr., La Jolla, CA 92093-0607Abstract |
Background |
Natriuretic peptides have prognostic value across a wide spectrum of cardiovascular diseases and may predict cognitive dysfunction in patients with cardiovascular disease, even in the absence of previous stroke. Little is known about the association of natriuretic peptides with cognitive function in community-dwelling adults. We assessed the association between N-terminal pro B-type natriuretic peptide (NT-proBNP) levels and cognitive function in community-dwelling ambulatory older adults in the Rancho Bernardo Study.
Methods |
We studied 950 men and women, aged 60 years and older, who attended a research clinic visit where a medical history and examination were performed, and blood for cardiovascular disease risk factors and NT-proBNP levels were obtained. Three cognitive function tests were administered: the Mini Mental State Examination (MMSE), Trail-Making Test B (Trails B), and Category Fluency.
Results |
Participants with high NT-proBNP levels (≥450 pg/mL; n=198) were older and had a higher prevalence of coronary heart disease (12% vs 30%), and stroke (5% vs 11%; P≤.001 for both). In unadjusted analyses, all 3 cognitive function test scores were significantly associated with NT-proBNP levels (P<.001). After adjusting for age, sex, education, hypertension, body mass index, exercise, alcohol use, smoking, low density lipoprotein cholesterol, creatinine clearance, and previous cardiovascular disease, elevated NT-proBNP levels remained independently associated with poor cognitive performance on MMSE (odds ratio [OR] 2.0; 95% confidence interval [CI], 1.1-3.6; P=.02) and Trails B (OR 1.7; 95% CI, 1.2-2.7; P=.01), but not Category Fluency (OR 1.4; 95% CI, 0.9-2.2; P=.19). Results were unchanged after excluding the 6% of participants with a history of stroke.
Conclusions |
NT-proBNP levels were strongly and independently associated with poor cognitive function in community-dwelling older adults.
Le texte complet de cet article est disponible en PDF.Keywords : Cardiovascular diseases, Cerebrovascular disorders, Cognitive function, Community, Elderly, Natriuretic peptides
Plan
| Funding: Supported by the National Institutes of Health (Grants AG07181, AG028507, and DK31801); American Heart Association (to Drs. Daniels and Laughlin); American College of Cardiology/Guidant Foundation (to Dr. Daniels). |
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| Conflict of Interest: Roche Diagnostics, Inc. supplied the reagents for analyzing the biomarkers for this report, but had no input into data acquisition, data analysis, manuscript preparation, or any other aspect of the study. Drs. Maisel and Daniels have received research grants from Roche Diagnostics; there are no other conflicts of interest to report. |
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| Authorship: All authors had access to the data and a role in writing the manuscript. |
Vol 124 - N° 7
P. 670.e1-670.e8 - juillet 2011 Retour au numéro
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