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O2‐09‐06: History of Vascular Disease and Risk of Dementia in the Oldest‐Old: The 90+ Study
Author(s) -
Corrada Maria M.,
Mozaffar Farah,
Evans Marcella A.,
Bullain Szofia S.,
Brookmeyer Ron,
Kawas Claudia H.
Publication year - 2016
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2016.06.447
Subject(s) - dementia , vascular dementia , medicine , stroke (engine) , diabetes mellitus , vascular disease , disease , heart failure , cohort , cohort study , population , endocrinology , mechanical engineering , environmental health , engineering
Background: Coronary artery bypass graft surgery (CABG) is increasingly used in the elderly as a successful treatment for coronary artery disease. However, the long-term association between CABG and dementia risk remains unclear. Methods:We used data from the US Cardiovascular Health Study, a large, prospective population-based study and included 3155 older adults, who were dementia free and had their history of CABG assessed at baseline. Participants were followed up for a median of 6 years (interquartile range 4.7-6.5). We used Cox proportional hazards regression models to examine the association between history of CABG and time to incident all-cause dementia, Alzheimer’s disease (AD), vascular dementia (VaD) and mixed dementia. Our models were adjusted for age, sex, ethnicity, education, baseline hypertension, diabetes and clinical or subclinical cardiovascular disease. Results: History of CABG almost doubled the risk of all-cause dementia (hazard ratio [HR] 1⁄4 1.93, 95% confidence interval [CI] 1⁄4 1.362.74) and almost tripled the risk of mixed dementia (HR 1⁄4 2.73, 95% CI 1⁄4 1.55-4.80) compared to no history of CABG. The associations with AD (HR1⁄4 1.71, 95%CI1⁄4 0.98-2.98) and VaD (HR1⁄4 1.42, 95% CI 1⁄4 0.56-3.65) were in the same direction though statistically not significant.When we compared the risk of incident allcause dementia and its subtypes in those with history of CABG to those with history of percutaneous coronary intervention, HRs suggested that history of CABG may be associated with a higher though statistically not significant risk of all-cause dementia and mixed dementia. However, these analyses were underpowered due to a small number of participants in the comparison group. Conclusions: History of CABG is a long-term risk factor for allcause dementia and mixed dementia. Further research is needed to clarify the mechanisms of this association and to compare CABG to alternative treatments strategies in terms of long-term dementia risk.