The N-terminal pro B-type natriuretic peptide, and risk of dementia and cognitive decline: a 10-year follow-up study in the general population.
In: Journal of Neurology, Neurosurgery & Psychiatry, Jg. 87 (2016-04-01), Heft 4, S. 356-362
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Background: The N-terminal pro B-type natriuretic peptide (NT-proBNP) has a well-documented prognostic value for cardiovascular disease (CVD) and higher levels are associated with cognitive-dysfunction in patients with CVD. However, how NT-proBNP relates to incident dementia and cognitive-decline in community-dwelling persons is unknown. Methods: Between 1997 and 2001, serum NT-proBNP was measured in 6040 participants (mean age 69 years, 57% women) free of heart-failure and dementia from the Rotterdam Study. Participants were continuously followed-up for incident dementia until 2012, for 56,616 person-years. Cognition was assessed at baseline and reassessed between 2002 and 2006 by Letter-Digit-Substitution-task, Stroop test and Word-Fluency test. Associations of NT-proBNP with dementia (555 cases), Alzheimer's disease (357 cases) and vascular dementia (32 cases) were assessed linearly, and in quartiles using Cox regression. Associations of NT-proBNP with cognitive-decline were assessed using multiple linear regression. All analyses were repeated after excluding patients with CVD. Results: Higher NT-proBNP was associated with a higher risk of dementia, even after excluding patients with CVD and adjusting for cardiovascular risk factors, HR per SD 1.27 (95% CI 1.13 to 1.44). Associations were particularly strong for vascular dementia, HR per SD 2.04 (95% CI 1.18 to 3.55), but also for Alzheimer's disease when comparing the second and third quartile with first. Higher NT-proBNP was cross-sectionally associated with poorer performance in multiple cognitive tests but longitudinally only in Letter-Digit-Substitution-task. Conclusions: NT-proBNP reflecting subclinical CVD is associated with dementia, particularly vascular dementia. NT-proBNP can be a useful marker of imminent cognitive-decline and dementia in absence of clinical CVD. [ABSTRACT FROM AUTHOR]
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The N-terminal pro B-type natriuretic peptide, and risk of dementia and cognitive decline: a 10-year follow-up study in the general population.
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Autor/in / Beteiligte Person: | Mirza, Saira Saeed ; de Bruijn, Renée F. A. G. ; Koudstaal, Peter J. ; van den Meiracker, Anton H. ; Franco, Oscar H. ; Hofman, Albert ; Tiemeier, Henning ; Ikram, M. Arfan |
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Zeitschrift: | Journal of Neurology, Neurosurgery & Psychiatry, Jg. 87 (2016-04-01), Heft 4, S. 356-362 |
Veröffentlichung: | 2016 |
Medientyp: | academicJournal |
ISSN: | 0022-3050 (print) |
DOI: | 10.1136/jnnp-2014-309968 |
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