Journal
JAMA NEUROLOGY
Volume 70, Issue 3, Pages 374-382Publisher
AMER MEDICAL ASSOC
DOI: 10.1001/jamaneurol.2013.607
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Funding
- Elan Pharmaceuticals
- National Institutes of Health [R01 AG011378, P50 AG016574, U01 AG006786, AG029550, AG032306, U01 096917, U01 AG024904, K01 MH068351, K01 AG028573]
- National Institute on Aging [P50 AG016574, U01 AG006786]
- Abbott Laboratories
- Driskill Foundation
- Robert H. and Clarice Smith and Abigail van Buren Alzheimer's Disease Research Program
- Rochester Epidemiology Project from the National Institute on Aging [R01 AG034676]
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Objective: To investigate the association of cardiac disease with amnestic and nonamnestic mild cognitive impairment (aMCI and naMCI, respectively). Nonamnestic mild cognitive impairment, a putative precursor of vascular and other non-Alzheimer dementias, is hypothesized to have a vascular etiology. Design: A prospective, population-based, cohort study with a median 4.0 years of follow-up. Setting: Olmsted County, Minnesota. Participants: A total of 2719 participants were evaluated at baseline and every 15 months using the Clinical Dementia Rating scale, a neurological evaluation, and neuropsychological testing. A diagnosis of normal cognition, MCI, or dementia was made by consensus. Cardiac disease at baseline was assessed from the participant's medical records. Main Outcome Measures: Incident MCI, aMCI, or naMCI. Results: Of 1450 participants without MCI or dementia at baseline, 366 developed MCI. Cardiac disease was associated with an increased risk of naMCI (hazard ratio, 1.77 [95% CI, 1.16-2.72]). However, the association varied by sex (P = .02 for interaction). Cardiac disease was associated with an increased risk of naMCI (hazard ratio, 3.07 [95% CI, 1.58-5.99]) for women but not for men (hazard ratio, 1.16 [95% CI, 0.68-1.99]). Cardiac disease was not associated with any type of MCI or with aMCI. Conclusions: Cardiac disease is an independent risk factor for naMCI; within-sex comparisons showed a stronger association for women. Prevention and management of cardiac disease and vascular risk factors may reduce the risk of naMCI. JAMA Neurol. 2013;70(3):374-382. Published online January 28, 2013. doi:10.1001/jamaneurol.2013.607
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