Open AccessCardiovascular Disease and Cognitive Decline in Postmenopausal Women: Results From the W omen's H ealth I nitiative M emory S tudy
Author(s) -
Haring Bernhard,
Leng Xiaoyan,
Robinson Jennifer,
Johnson Karen C.,
Jackson Rebecca D.,
Beyth Rebecca,
WactawskiWende Jean,
Ballmoos Moritz Wyler,
Goveas Joseph S.,
Kuller Lewis H.,
WassertheilSmoller Sylvia
Publication year - 2013
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.113.000369
Subject(s) - medicine , cognitive decline , dementia , diabetes mellitus , hazard ratio , myocardial infarction , neurocognitive , cognition , stroke (engine) , atrial fibrillation , disease , cardiology , psychiatry , endocrinology , confidence interval , mechanical engineering , engineering
Background Data on cardiovascular diseases ( CVD ) and cognitive decline are conflicting. Our objective was to investigate if CVD is associated with an increased risk for cognitive decline and to examine whether hypertension, diabetes, or adiposity modify the effect of CVD on cognitive functioning. Methods and Results Prospective follow‐up of 6455 cognitively intact, postmenopausal women aged 65 to 79 years old enrolled in the W omen's H ealth I nitiative M emory S tudy ( WHIMS ). CVD was determined by self‐report. For cognitive decline, we assessed the incidence of mild cognitive impairment ( MCI ) or probable dementia ( PD ) via modified mini‐mental state examination (3 MS) score, neurocognitive, and neuropsychiatric examinations. The median follow‐up was 8.4 years. Women with CVD tended to be at increased risk for cognitive decline compared with those free of CVD (hazard ratio [ HR ], 1.29; 95% CI : 1.00, 1.67). Women with myocardial infarction or other vascular disease were at highest risk ( HR , 2.10; 95% CI : 1.40, 3.15 or HR , 1.97; 95% CI : 1.34, 2.87). Angina pectoris was moderately associated with cognitive decline ( HR 1.45; 95% CI : 1.05, 2.01) whereas no significant relationships were found for atrial fibrillation or heart failure. Hypertension and diabetes increased the risk for cognitive decline in women without CVD . Diabetes tended to elevate the risk for MCI / PD in women with CVD . No significant trend was seen for adiposity. Conclusions CVD is associated with cognitive decline in elderly postmenopausal women. Hypertension and diabetes, but not adiposity, are associated with a higher risk for cognitive decline. More research is warranted on the potential of CVD prevention for preserving cognitive functioning.