Cardiovascular disease (CVD) is associated with cognitive deficits long before the onset of stroke or dementia. Recent work has extended these findings and shown that patients with congestive heart failure also exhibit reduced cognitive performance. Brain natriuretic peptide (BNP) is used to help diagnose heart failure, but no study has examined whether BNP predicts cognitive dysfunction in older patients with CVD. BNP values and performance on the Dementia Rating Scale were assessed in 56 older adults with documented CVD. Forty-eight percent of the participants were women, and their average age was 70 ± 8 years. All participants had Mini-Mental State Examination scores greater than the cutoff for dementia and no histories of neurologic or severe psychiatric disorders. The average BNP level was 122 ± 202 pg/ml. Hierarchical regression analyses showed that logtransformed BNP levels predicted Dementia Rating Scale total score after adjusting for possible demographic and medical confounders (ΔR 2 = 0.09, F[1, 44] = 6.14, p = 0.017). Partial correlation analysis adjusting for these possible confounders showed a particularly strong relation to the conceptualization subtest (r = −0.44, p = 0.002), a measure of verbal and nonverbal abstraction abilities. In conclusion, the results of the present study provide the first evidence for an independent relation between BNP and cognitive dysfunction in older adults with CVD.We hypothesized that brain natriuretic peptide (BNP) levels might predict cognitive dysfunction and assessed BNP levels and cognitive performance in a sample of older adults with documented stable cardiovascular disease (CVD).The following methods were approved by the local institutional review board, and all participants provided written informed consent.Fifty-six participants enrolled in a larger, prospective study of the neurocognitive consequences of CVD were included in the present study. For inclusion into the parent study, all participants had to have documented histories of CVD, be between the ages of 55 and 85 years, have MiniMental State Examination total scores greater than the cutoff for dementia, 1 and have no histories of neurologic or severe psychiatric disorders (e.g., stroke, bipolar disorder). The demographic and medical characteristics of the sample are presented in Table 1. BNP levels were obtained on the same day as the neuropsychologic battery was conducted and <3 weeks after cardiac evaluation. BNP levels were quantified using the Bayer Advia Centaur (Bayer HealthCare, Tarrytown, New York). Blood samples were sent to the local laboratory for analysis. To promote comparison with past studies, BNP levels were log transformed before statistical analysis to adjust for the skewed distribution. 2 The Dementia Rating Scale (DRS) is a commonly used neuropsychologic measure that is sensitive to dementia and cognitive decrease in older adults. [3][4][5] In addition to the DRS total score, 5 subtests assess function in different cognitive domains, namely, attention, initiation and pers...