Open AccessNT‐proBNP and Risk of Dementia in a General Japanese Elderly Population: The Hisayama Study
Author(s) -
Nagata Takuya,
Ohara Tomoyuki,
Hata Jun,
Sakata Satoko,
Furuta Yoshihiko,
Yoshida Daigo,
Honda Takanori,
Hirakawa Yoichiro,
Ide Tomomi,
Kanba Shigenobu,
Kitazono Takanari,
Tsutsui Hiroyuki,
Ninomiya Toshiharu
Publication year - 2019
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.118.011652
Subject(s) - medicine , dementia , population , cardiology , gerontology , intensive care medicine , pediatrics , disease , environmental health
Background Epidemiological evidence implies a link between heart disease and dementia. However, few prospective studies have assessed the association between serum NT ‐pro BNP (N‐terminal pro–B‐type natriuretic peptide) levels and dementia. Methods and Results A total of 1635 community‐dwelling Japanese elderly aged ≥60 years without dementia (57% women, mean age±SD 70.8±7.7 years) were followed up for 10 years. Serum NT ‐pro BNP levels were divided into 4 categories (≤54, 55‐124, 125‐299, and ≥300 pg/mL). The hazard ratios were estimated using a Cox proportional hazards model. During the follow‐up period, 377 subjects developed all‐cause dementia, 247 Alzheimer disease, and 102 vascular dementia. The age‐ and sex‐adjusted incidence of all‐cause dementia was 31.5 per 1000 person‐years and increased significantly with higher serum NT ‐pro BNP levels, being 16.4, 32.0, 35.7, and 45.5, respectively ( P for trend <0.01). Subjects with serum NT ‐pro BNP levels of ≥300 pg/mL had a significantly higher risk of all‐cause dementia (hazard ratio=2.46, 95% CI 1.63‐3.71) than those with serum NT ‐pro BNP levels of ≤54 pg/ mL after adjusting for confounders. Similar risks were observed for Alzheimer disease and vascular dementia. Incorporation of the serum NT ‐pro BNP level into a model with known risk factors for dementia significantly improved the predictive ability for incident dementia (c‐statistics 0.780‐0.787, P =0.02; net reclassification improvement 0.189, P =0.001; integrated discrimination improvement 0.011, P =0.003). Conclusions Higher serum NT ‐pro BNP levels were significantly associated with an increased risk of dementia. Serum NT ‐pro BNP could be a novel biomarker for predicting future risk of dementia in the general elderly population.