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Elevated natriuretic peptide levels and cognitive function in community-dwelling older adults.
Am J Med. 2011 Jul; 124(7):670.e1-8.AJ

Abstract

BACKGROUND

Natriuretic peptides have prognostic value across a wide spectrum of cardiovascular diseases and may predict cognitive dysfunction in patients with cardiovascular disease, even in the absence of previous stroke. Little is known about the association of natriuretic peptides with cognitive function in community-dwelling adults. We assessed the association between N-terminal pro B-type natriuretic peptide (NT-proBNP) levels and cognitive function in community-dwelling ambulatory older adults in the Rancho Bernardo Study.

METHODS

We studied 950 men and women, aged 60 years and older, who attended a research clinic visit where a medical history and examination were performed, and blood for cardiovascular disease risk factors and NT-proBNP levels were obtained. Three cognitive function tests were administered: the Mini Mental State Examination (MMSE), Trail-Making Test B (Trails B), and Category Fluency.

RESULTS

Participants with high NT-proBNP levels (≥450 pg/mL; n=198) were older and had a higher prevalence of coronary heart disease (12% vs 30%), and stroke (5% vs 11%; P≤.001 for both). In unadjusted analyses, all 3 cognitive function test scores were significantly associated with NT-proBNP levels (P<.001). After adjusting for age, sex, education, hypertension, body mass index, exercise, alcohol use, smoking, low density lipoprotein cholesterol, creatinine clearance, and previous cardiovascular disease, elevated NT-proBNP levels remained independently associated with poor cognitive performance on MMSE (odds ratio [OR] 2.0; 95% confidence interval [CI], 1.1-3.6; P=.02) and Trails B (OR 1.7; 95% CI, 1.2-2.7; P=.01), but not Category Fluency (OR 1.4; 95% CI, 0.9-2.2; P=.19). Results were unchanged after excluding the 6% of participants with a history of stroke.

CONCLUSIONS

NT-proBNP levels were strongly and independently associated with poor cognitive function in community-dwelling older adults.

Authors+Show Affiliations

Division of Cardiology, Department of Medicine, University of California at San Diego, USA. lbdaniels@ucsd.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21683832

Citation

Daniels, Lori B., et al. "Elevated Natriuretic Peptide Levels and Cognitive Function in Community-dwelling Older Adults." The American Journal of Medicine, vol. 124, no. 7, 2011, pp. 670.e1-8.
Daniels LB, Laughlin GA, Kritz-Silverstein D, et al. Elevated natriuretic peptide levels and cognitive function in community-dwelling older adults. Am J Med. 2011;124(7):670.e1-8.
Daniels, L. B., Laughlin, G. A., Kritz-Silverstein, D., Clopton, P., Chen, W. C., Maisel, A. S., & Barrett-Connor, E. (2011). Elevated natriuretic peptide levels and cognitive function in community-dwelling older adults. The American Journal of Medicine, 124(7), e1-8. https://doi.org/10.1016/j.amjmed.2011.02.027
Daniels LB, et al. Elevated Natriuretic Peptide Levels and Cognitive Function in Community-dwelling Older Adults. Am J Med. 2011;124(7):670.e1-8. PubMed PMID: 21683832.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Elevated natriuretic peptide levels and cognitive function in community-dwelling older adults. AU - Daniels,Lori B, AU - Laughlin,Gail A, AU - Kritz-Silverstein,Donna, AU - Clopton,Paul, AU - Chen,Wei-Chung, AU - Maisel,Alan S, AU - Barrett-Connor,Elizabeth, PY - 2010/12/21/received PY - 2011/02/22/revised PY - 2011/02/23/accepted PY - 2011/6/21/entrez PY - 2011/6/21/pubmed PY - 2011/8/13/medline SP - 670.e1 EP - 8 JF - The American journal of medicine JO - Am. J. Med. VL - 124 IS - 7 N2 - BACKGROUND: Natriuretic peptides have prognostic value across a wide spectrum of cardiovascular diseases and may predict cognitive dysfunction in patients with cardiovascular disease, even in the absence of previous stroke. Little is known about the association of natriuretic peptides with cognitive function in community-dwelling adults. We assessed the association between N-terminal pro B-type natriuretic peptide (NT-proBNP) levels and cognitive function in community-dwelling ambulatory older adults in the Rancho Bernardo Study. METHODS: We studied 950 men and women, aged 60 years and older, who attended a research clinic visit where a medical history and examination were performed, and blood for cardiovascular disease risk factors and NT-proBNP levels were obtained. Three cognitive function tests were administered: the Mini Mental State Examination (MMSE), Trail-Making Test B (Trails B), and Category Fluency. RESULTS: Participants with high NT-proBNP levels (≥450 pg/mL; n=198) were older and had a higher prevalence of coronary heart disease (12% vs 30%), and stroke (5% vs 11%; P≤.001 for both). In unadjusted analyses, all 3 cognitive function test scores were significantly associated with NT-proBNP levels (P<.001). After adjusting for age, sex, education, hypertension, body mass index, exercise, alcohol use, smoking, low density lipoprotein cholesterol, creatinine clearance, and previous cardiovascular disease, elevated NT-proBNP levels remained independently associated with poor cognitive performance on MMSE (odds ratio [OR] 2.0; 95% confidence interval [CI], 1.1-3.6; P=.02) and Trails B (OR 1.7; 95% CI, 1.2-2.7; P=.01), but not Category Fluency (OR 1.4; 95% CI, 0.9-2.2; P=.19). Results were unchanged after excluding the 6% of participants with a history of stroke. CONCLUSIONS: NT-proBNP levels were strongly and independently associated with poor cognitive function in community-dwelling older adults. SN - 1555-7162 UR - https://www.unboundmedicine.com/medline/citation/21683832/Elevated_natriuretic_peptide_levels_and_cognitive_function_in_community_dwelling_older_adults_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9343(11)00278-6 DB - PRIME DP - Unbound Medicine ER -