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Heart failure and risk of dementia and Alzheimer disease: a population-based cohort study.
Arch Intern Med. 2006 May 08; 166(9):1003-8.AI

Abstract

BACKGROUND

Heart failure has been linked to cognitive impairment in several previous studies, but to our knowledge, no investigations have explored the relationship between heart failure and the risk of dementia. We sought to examine the hypothesis that heart failure is a risk factor for dementia and Alzheimer disease.

METHODS

A community-based cohort of 1301 individuals 75 years or older and without dementia in Stockholm, Sweden, was examined 3 times over a 9-year period to detect patients with dementia and Alzheimer disease using the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition. Heart failure was defined according to the guidelines of the Task Force on Heart Failure of the European Society of Cardiology by integrating clinical symptoms and signs with inpatient register entries and use of cardiac medications. Data were analyzed using Cox proportional hazards models with adjustment for major potential confounders.

RESULTS

During the 6534 person-years of follow-up (mean, 5.02 years per person), 440 subjects were diagnosed as having dementia, including 333 with Alzheimer disease. At baseline, heart failure was identified in 205 subjects. Heart failure was associated with a multi-adjusted hazard ratio (HR) of 1.84 (95% confidence interval [CI], 1.35-2.51) for dementia and 1.80 (95% CI, 1.25-2.61) for Alzheimer disease. Use of antihypertensive drugs (83% of which are diuretics) seemed to reduce dementia risk due to heart failure (HR, 1.38; 95% CI, 0.99-1.94). Heart failure and low diastolic pressure (< 70 mm Hg) had an additive effect on the risk for dementia (HR, 3.07; 95% CI, 1.67-5.61).

CONCLUSIONS

Heart failure is associated with an increased risk of dementia and Alzheimer disease in older adults. Antihypertensive drug therapy may partially counteract the risk effect of heart failure on dementia disorders.

Authors+Show Affiliations

Qiu C
Aging Research Center, Division of Geriatric Epidemiology and Medicine, Department of Neurotec, Karolinska Institutet and Stockholm Gerontology Research Center, Olivecronas väg 4, S-113 82 Stockholm, Sweden. chengxuan.qiu@ki.se
Winblad B
No affiliation info available
Marengoni A
No affiliation info available
Klarin I
No affiliation info available
Fastbom J
No affiliation info available
Fratiglioni L
No affiliation info available

MeSH

AgedAged, 80 and overAlzheimer DiseaseAntihypertensive AgentsCohort StudiesDementiaFemaleFollow-Up StudiesHeart FailureHumansMaleOdds RatioRisk AssessmentRisk FactorsSweden

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16682574

Citation

Qiu, Chengxuan, et al. "Heart Failure and Risk of Dementia and Alzheimer Disease: a Population-based Cohort Study." Archives of Internal Medicine, vol. 166, no. 9, 2006, pp. 1003-8.
Qiu C, Winblad B, Marengoni A, et al. Heart failure and risk of dementia and Alzheimer disease: a population-based cohort study. Arch Intern Med. 2006;166(9):1003-8.
Qiu, C., Winblad, B., Marengoni, A., Klarin, I., Fastbom, J., & Fratiglioni, L. (2006). Heart failure and risk of dementia and Alzheimer disease: a population-based cohort study. Archives of Internal Medicine, 166(9), 1003-8.
Qiu C, et al. Heart Failure and Risk of Dementia and Alzheimer Disease: a Population-based Cohort Study. Arch Intern Med. 2006 May 8;166(9):1003-8. PubMed PMID: 16682574.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Heart failure and risk of dementia and Alzheimer disease: a population-based cohort study. AU - Qiu,Chengxuan, AU - Winblad,Bengt, AU - Marengoni,Alessandra, AU - Klarin,Inga, AU - Fastbom,Johan, AU - Fratiglioni,Laura, PY - 2006/5/10/pubmed PY - 2006/5/24/medline PY - 2006/5/10/entrez SP - 1003 EP - 8 JF - Archives of internal medicine JO - Arch Intern Med VL - 166 IS - 9 N2 - BACKGROUND: Heart failure has been linked to cognitive impairment in several previous studies, but to our knowledge, no investigations have explored the relationship between heart failure and the risk of dementia. We sought to examine the hypothesis that heart failure is a risk factor for dementia and Alzheimer disease. METHODS: A community-based cohort of 1301 individuals 75 years or older and without dementia in Stockholm, Sweden, was examined 3 times over a 9-year period to detect patients with dementia and Alzheimer disease using the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition. Heart failure was defined according to the guidelines of the Task Force on Heart Failure of the European Society of Cardiology by integrating clinical symptoms and signs with inpatient register entries and use of cardiac medications. Data were analyzed using Cox proportional hazards models with adjustment for major potential confounders. RESULTS: During the 6534 person-years of follow-up (mean, 5.02 years per person), 440 subjects were diagnosed as having dementia, including 333 with Alzheimer disease. At baseline, heart failure was identified in 205 subjects. Heart failure was associated with a multi-adjusted hazard ratio (HR) of 1.84 (95% confidence interval [CI], 1.35-2.51) for dementia and 1.80 (95% CI, 1.25-2.61) for Alzheimer disease. Use of antihypertensive drugs (83% of which are diuretics) seemed to reduce dementia risk due to heart failure (HR, 1.38; 95% CI, 0.99-1.94). Heart failure and low diastolic pressure (< 70 mm Hg) had an additive effect on the risk for dementia (HR, 3.07; 95% CI, 1.67-5.61). CONCLUSIONS: Heart failure is associated with an increased risk of dementia and Alzheimer disease in older adults. Antihypertensive drug therapy may partially counteract the risk effect of heart failure on dementia disorders. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/16682574/Heart_failure_and_risk_of_dementia_and_Alzheimer_disease:_a_population_based_cohort_study_ DB - PRIME DP - Unbound Medicine ER -