Cognitive impairment and risk of cardiovascular events and mortality

O’Donnell, Martin; Teo, Koon; Gao, Peggy; Anderson, Craig S.; Sleight, Peter; Dans, Antonio; Marzona, Irene; Bosch, Jackie; Probstfield, Jeffrey L.; Yusuf, Salim

doi:10.1093/eurheartj/ehs053

Cited by 119 publications

(136 citation statements)

References 37 publications

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“…Most recent population‐based epidemiological studies have extensively reported a consistent association between cognitive impairment and increased risk of all‐cause mortality in the elderly, and MMSE score as a common measure of cognitive impairment has been a powerful and independent predictor of all‐cause mortality 4, 7, 16, 21. To the best of our knowledge, only 2 studies have examined the relationship between baseline cognitive function and mortality in China 5, 6.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, it has been suggested that cognitive impairment provides predictive value for CVD, although the underlying pathological mechanisms of any correlations are less clear 7, 8. The accumulating evidence in support of the association between cognitive impairment and CVD led to formulation of the hypothesis that MMSE score might also provide additional predictive value for CVD mortality 16.…”

Section: Discussionmentioning

confidence: 99%

“…Several recent studies have suggested that worse cognitive function, as measured by various cognitive tests, is related to the risk of CVD mortality 12, 13, 15. Regarding the use of the MMSE to assess cognitive function, an analysis of the ONTARGET (ONgoing Telmisartan Alone and in Combination With Ramipril … Alone and combination with Ramipril global Endpoint trial) and TRANSCEND (Telmisartan Random‐ ized Assessment Study in ACE‐Intolerant Subjects with Cardiovascular Disease) trials reported that baseline MMSE score was a significant predictor of cardiovascular mortality among the population of patients at high risk for CVD 7. However, a previous study demonstrated that mild cognitive impairment was associated with cardiovascular mortality only when studied separately or in a sex‐ and age‐adjusted model, whereas in a multivariable model the MMSE score lost its significance 16.…”

Section: Discussionmentioning

confidence: 99%

“…In our analysis, we adjusted for age and sex in model 2 and demographic characteristics and lifestyle in model 3 because these factors were common potential confounders between cognitive function and mortality risk 7, 12. In addition to common factors, we were able to adjust for physical health and medications in model 4 that may also confound the relationship.…”

Section: Discussionmentioning

confidence: 99%

“…Cognitive impairment predicts CVD events independently in addition to traditional risk factors, such as hypertension, smoking, diabetes mellitus, lipid abnormality, increasing age, overweight, and obesity 7, 8. Several risk factors for CVD are also risk factors for cognitive impairment 9.…”

Section: Introductionmentioning

confidence: 99%

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Cognitive Impairment and Risk of All‐Cause and Cardiovascular Disease Mortality Over 20‐Year Follow‐up: Results From the BLSA

Tang

et al. 2018

JAHA

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BackgroundCognitive impairment may increase the risk of all‐cause and cardiovascular disease (CVD) mortality. This study examined the association between cognitive function and risk of all‐cause and CVD mortality among the elderly in Beijing, China.Methods and ResultsA total of 1996 participants aged ≥55 years at baseline were enrolled from the BLSA (Beijing Longitudinal Study of Aging). Cognitive function was assessed using the Mini‐Mental State Examination (MMSE), and participants were categorized as: <18, 18 to 23, 24 to 27, and 28 to 30. Cox proportional hazard models were used to estimate the association. Hazard ratio (HR) and 95% confidence interval (CI) were reported. During a 20‐year follow‐up, 1122 (56.21%) participants died, 478 (42.60%) of whom died of CVD. Compared with MMSE scores of 28 to 30, participants with MMSE scores of <18 were independently associated with all‐cause mortality (hazard ratio, 2.14; 95% confidence interval, 1.59–2.87; P<0.001) and CVD mortality (hazard ratio, 4.52; 95% confidence interval, 2.80–7.30, P<0.001). Each 5‐point decrease in MMSE score was associated with a 34% increased risk of all‐cause mortality and a 56% increased risk of CVD mortality. This relationship remained statistically significant after using the competing risk model to consider non‐CVD death as a competing risk event.ConclusionCognitive impairment measured by MMSE score was associated with elevated risk of all‐cause and CVD mortality among the elderly in Beijing, China.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cognitive Impairment and Risk of All‐Cause and Cardiovascular Disease Mortality Over 20‐Year Follow‐up: Results From the BLSA

Tang

et al. 2018

JAHA

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Comparison of different protocols of Morris water maze in cognitive impairment with heart failure

Yang

Wang

et al. 2020

Brain and Behavior

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Aim This study aimed to find a more sensitive and systematic behavioral evaluation protocol to evaluate the cognitive impairment in rats with heart failure (HF). Methods and results An HF rat model was built by ligating the left anterior descending coronary artery. The cardiac function and structure were detected using echocardiography. Myocardial histopathological changes were observed by nitro blue tetrazolium and hematoxylin–eosin staining. The cognitive functions were evaluated using the acquisition task, probe trial, reversal test, and matching‐to‐sample test of the Morris water maze. In the probe trial, the number of times the rats in the model group crossed the platform site significantly decreased compared with that in the sham group. In the reversal test, the average latency was significantly longer in the sham group compared with the model group in the first trial but was shorter in the second and third trials. In the matching‐to‐sample test, the average latency of Trial1 increased significantly in the model group compared with the sham group, while no obvious difference was observed in Trial2. Therefore, the difference in the average latency between Trial1 and Trial2 of the model group was significantly larger. Conclusions The cognitive impairment in rats with HF mainly reflected in the long‐term and working memory, spatial learning, and reversal learning ability. The probe trial and reversal test in the water maze may be more sensitive and preferred to evaluate cognitive function after HF. These findings would provide a brief evaluation protocol for further studies on the relationship between cognitive function and HF.

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Cognition, even in the normal range, predicts disability: cross‐sectional and prospective analyses of a population‐based sample

John

Tyas

Montgomery

2015

Int J Geriat Psychiatry

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Cognitive impairment and risk of cardiovascular events and mortality

Abstract: In people at increased CV risk, impairments on baseline cognitive testing are associated with a graded increase in the risk of stroke, congestive heart failure, and CV death, but not coronary events. An MMSE score of <24 increased CV disease risk to the same extent as a previous stroke.

Cited by 119 publications

References 37 publications

Cognitive Impairment and Risk of All‐Cause and Cardiovascular Disease Mortality Over 20‐Year Follow‐up: Results From the BLSA

Cognitive Impairment and Risk of All‐Cause and Cardiovascular Disease Mortality Over 20‐Year Follow‐up: Results From the BLSA

Comparison of different protocols of Morris water maze in cognitive impairment with heart failure

Cognition, even in the normal range, predicts disability: cross‐sectional and prospective analyses of a population‐based sample

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