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B-type natriuretic peptide as a predictor of declining cognitive function and dementia--a cohort study of an elderly general population with a 5-year follow-up.

Abstract

BACKGROUND

Several traditional cardiovascular risk factors assessed in the middle-aged are associated with the risk of dementia, but they are known to lose much of their prognostic value when measured in the elderly. The aim of the study was to compare B-type natriuretic peptide (BNP) with previously known risk markers for dementia in their association with cognitive decline and dementia during a follow-up.

METHODS

A total of 464 subjects free of dementia aged 75 years or more were examined and followed up for 5 years in a prospective population-based stratified cohort study. The association of clinical variables to base-line Mini Mental State Examination score (MMSE), the decline of MMSE, and onset of dementia during the follow-up were examined.

RESULTS

The only variable to significantly associate with the decline of MMSE was BNP (beta 0.140; P = 0.019). A total of 59 new cases of dementia were diagnosed after the follow-up. Significant predictors of the occurrence of dementia over the study period were BNP (adjusted odds ratio (OR) 1.53; 95% confidence interval (CI) 1.09-2.16; P = 0.013), length of education (OR 0.50; 95% CI 0.33-0.77; P = 0.001), and diagnosis of hypertension (OR 0.53; 95% CI 0.27-0.95; P = 0.036). BNP remained as a significant predictor of dementia and the decline of MMSE even after adjustment to the base-line MMSE.

CONCLUSIONS

BNP is an independent harbinger of the cognitive decline and incidence of new onset of dementia in an elderly general population. This is a ground for testing the impact of antihypertensive treatment in the prevention of cognitive impairment in those with elevated BNP.

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  • Authors+Show Affiliations

    ,

    Department of Internal Medicine, Päijät-Häme Central Hospital, Lahti, Finland. tuomas.kerola@phsotey.fi

    , , , ,

    Source

    Annals of medicine 42:3 2010 Apr pg 207-15

    MeSH

    Aged
    Aged, 80 and over
    Cognition
    Cognition Disorders
    Cohort Studies
    Dementia
    Educational Status
    Female
    Finland
    Follow-Up Studies
    Humans
    Hypertension
    Male
    Multivariate Analysis
    Natriuretic Peptide, Brain
    Predictive Value of Tests
    Risk Factors

    Pub Type(s)

    Comparative Study
    Journal Article
    Randomized Controlled Trial

    Language

    eng

    PubMed ID

    20384435

    Citation

    Kerola, Tuomas, et al. "B-type Natriuretic Peptide as a Predictor of Declining Cognitive Function and Dementia--a Cohort Study of an Elderly General Population With a 5-year Follow-up." Annals of Medicine, vol. 42, no. 3, 2010, pp. 207-15.
    Kerola T, Nieminen T, Hartikainen S, et al. B-type natriuretic peptide as a predictor of declining cognitive function and dementia--a cohort study of an elderly general population with a 5-year follow-up. Ann Med. 2010;42(3):207-15.
    Kerola, T., Nieminen, T., Hartikainen, S., Sulkava, R., Vuolteenaho, O., & Kettunen, R. (2010). B-type natriuretic peptide as a predictor of declining cognitive function and dementia--a cohort study of an elderly general population with a 5-year follow-up. Annals of Medicine, 42(3), pp. 207-15. doi:10.3109/07853891003652542.
    Kerola T, et al. B-type Natriuretic Peptide as a Predictor of Declining Cognitive Function and Dementia--a Cohort Study of an Elderly General Population With a 5-year Follow-up. Ann Med. 2010;42(3):207-15. PubMed PMID: 20384435.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - B-type natriuretic peptide as a predictor of declining cognitive function and dementia--a cohort study of an elderly general population with a 5-year follow-up. AU - Kerola,Tuomas, AU - Nieminen,Tuomo, AU - Hartikainen,Sirpa, AU - Sulkava,Raimo, AU - Vuolteenaho,Olli, AU - Kettunen,Raimo, PY - 2010/4/14/entrez PY - 2010/4/14/pubmed PY - 2010/6/19/medline SP - 207 EP - 15 JF - Annals of medicine JO - Ann. Med. VL - 42 IS - 3 N2 - BACKGROUND: Several traditional cardiovascular risk factors assessed in the middle-aged are associated with the risk of dementia, but they are known to lose much of their prognostic value when measured in the elderly. The aim of the study was to compare B-type natriuretic peptide (BNP) with previously known risk markers for dementia in their association with cognitive decline and dementia during a follow-up. METHODS: A total of 464 subjects free of dementia aged 75 years or more were examined and followed up for 5 years in a prospective population-based stratified cohort study. The association of clinical variables to base-line Mini Mental State Examination score (MMSE), the decline of MMSE, and onset of dementia during the follow-up were examined. RESULTS: The only variable to significantly associate with the decline of MMSE was BNP (beta 0.140; P = 0.019). A total of 59 new cases of dementia were diagnosed after the follow-up. Significant predictors of the occurrence of dementia over the study period were BNP (adjusted odds ratio (OR) 1.53; 95% confidence interval (CI) 1.09-2.16; P = 0.013), length of education (OR 0.50; 95% CI 0.33-0.77; P = 0.001), and diagnosis of hypertension (OR 0.53; 95% CI 0.27-0.95; P = 0.036). BNP remained as a significant predictor of dementia and the decline of MMSE even after adjustment to the base-line MMSE. CONCLUSIONS: BNP is an independent harbinger of the cognitive decline and incidence of new onset of dementia in an elderly general population. This is a ground for testing the impact of antihypertensive treatment in the prevention of cognitive impairment in those with elevated BNP. SN - 1365-2060 UR - https://www.unboundmedicine.com/medline/citation/20384435/B_type_natriuretic_peptide_as_a_predictor_of_declining_cognitive_function_and_dementia__a_cohort_study_of_an_elderly_general_population_with_a_5_year_follow_up_ L2 - http://www.tandfonline.com/doi/full/10.3109/07853891003652542 DB - PRIME DP - Unbound Medicine ER -