N‐terminal pro–brain natriuretic peptide and cognitive decline in older adults at high cardiovascular risk. Issue 2 (9th July 2014)

• Record Type: Journal Article
• Authors: Wijsman, Liselotte W.; Sabayan, Behnam; van Vliet, Peter; Trompet, Stella; de Ruijter, Wouter; Poortvliet, Rosalinde K. E.; van Peet, Petra G.; Gussekloo, Jacobijn; Jukema, J. Wouter; Stott, David J.; Sattar, Naveed; Ford, Ian; Westendorp, Rudi G. J.; de Craen, Anton J. M.; Mooijaart, Simon P.
• Is Part Of: Annals of neurology. Volume 76:Issue 2(2014:Aug.)
• Page Start: 213
• Page End: 222
• Publication Date: 2014-07-09
• Subjects: Neurology -- Periodicals; Pediatric neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; 616.8
• DOI: 10.1002/ana.24203
• Languages: English
• ISSNs: 0364-5134

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ana24203-sec-0001" sec-type="section"> <title>Objective</title> <p>Elevated levels of N‐terminal pro–brain natriuretic peptide (NT‐proBNP) are associated with cognitive impairment, which might be explained by cardiovascular diseases or risk factors. The aim of this study was to investigate the association of NT‐proBNP with cognitive function and decline in older adults at high risk of cardiovascular disease.</p> </sec> <sec id="ana24203-sec-0002" sec-type="section"> <title>Methods</title> <p>We studied 5, 205 men and women (mean age = 75 years) who were recruited into the PROspective Study of Pravastatin in the Elderly at Risk. All participants had pre‐existing cardiovascular disease or risk factors thereof. Four domains of cognitive function were tested at baseline and repeated during a follow‐up period of 3.2 years.</p> </sec> <sec id="ana24203-sec-0003" sec-type="section"> <title>Results</title> <p>Participants with higher NT‐proBNP (≥450ng/l) had worse baseline cognitive function, including reaction time (mean difference high vs low group = 3.07 seconds, 95% confidence interval [CI] = 0.83 to 5.32), processing speed (−1.02 digits coded, 95% CI = −1.65 to −0.39), and immediate memory (−0.13 pictures remembered, 95% CI = −0.29 to 0.04). There was no significant difference in delayed memory (−0.14, 95% CI = −0.38 to 0.10) between the NT‐proBNP groups. Participants with higher NT‐proBNP had a steeper cognitive decline, including reaction time (mean annual change high vs low group = 0.60 seconds, 95% CI = 0.14 to 1.07), processing speed (−0.15 digits coded, 95% CI = −0.25 to −0.05), immediate memory (−0.05 pictures remembered, 95% CI = −0.09 to 0.00), and delayed memory (−0.05 pictures remembered, 95% CI = −0.11 to 0.01). Associations were independent of cardiovascular diseases and risks.</p> </sec> <sec id="ana24203-sec-0004" sec-type="section"> <title>Interpretation</title> <p>Higher NT‐proBNP associates with worse cognitive function and steeper cognitive decline, independent of cardiovascular diseases and risks. Further studies to unravel the underlying mechanisms are warranted. Ann Neurol 2014;76:213–222</p> </sec> </abstract>