TY - JOUR
T1 - Vascular risk factors and cognitive impairment in a stroke-free cohort
AU - Unverzagt, F. W.
AU - McClure, L. A.
AU - Wadley, V. G.
AU - Jenny, N. S.
AU - Go, R. C.
AU - Cushman, M.
AU - Kissela, B. M.
AU - Kelley, B. J.
AU - Kennedy, R.
AU - Moy, C. S.
AU - Howard, V.
AU - Howard, G.
N1 - Funding Information:
Study funding: This research project is supported by a cooperative agreement U01 NS041588 from the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Department of Health and Human Services . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Neurological Disorders and Stroke or the National Institutes of Health. Representatives of the funding agency have been involved in the review of the manuscript but not directly involved in the collection, management, analysis, or interpretation of the data.
PY - 2011/11/8
Y1 - 2011/11/8
N2 - Objective: To examine vascular risk factors, as measured by the Framingham Stroke Risk Profile (FSRP), to predict incident cognitive impairment in a large, national sample of black and white adults age 45 years and older. Methods: Participants included subjects without stroke at baseline from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study with at least 2 cognitive function assessments during the follow-up (n=23,752). Incident cognitive impairment was defined as decline from a baseline score of 5 or 6 (of possible 6 points) to the most recent follow-up score of 4 or less on the Six-item Screener (SIS). Subjects with suspected stroke during follow-up were censored. Results: During a mean follow-up of 4.1 years, 1,907 participants met criteria for incident cognitive impairment. Baseline FSRP score was associated with incident cognitive impairment. An adjusted model revealed that male sex (odds ratio [OR]=1.59, 95% confidence interval [CI] 1.43-1.77), black race (OR=2.09, 95% CI 1.88-2.35), less education (less than high school graduate vs college graduate, OR=2.21, 95% CI 1.88-2.60), older age (10-year increments, OR=2.11, per 10-year increase in age, 95% CI 2.05-2.18), and presence of left ventricular hypertrophy (LVH, OR=1.29, 95% CI 1.06-1.58) were related to development of cognitive impairment. When LVH was excluded from the model, elevated systolic blood pressure was related to incident cognitive impairment. Conclusions: Total FSRP score, elevated blood pressure, and LVH predict development of clinically significant cognitive dysfunction. Prevention and treatment of high blood pressure may be effective in preserving cognitive health.
AB - Objective: To examine vascular risk factors, as measured by the Framingham Stroke Risk Profile (FSRP), to predict incident cognitive impairment in a large, national sample of black and white adults age 45 years and older. Methods: Participants included subjects without stroke at baseline from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study with at least 2 cognitive function assessments during the follow-up (n=23,752). Incident cognitive impairment was defined as decline from a baseline score of 5 or 6 (of possible 6 points) to the most recent follow-up score of 4 or less on the Six-item Screener (SIS). Subjects with suspected stroke during follow-up were censored. Results: During a mean follow-up of 4.1 years, 1,907 participants met criteria for incident cognitive impairment. Baseline FSRP score was associated with incident cognitive impairment. An adjusted model revealed that male sex (odds ratio [OR]=1.59, 95% confidence interval [CI] 1.43-1.77), black race (OR=2.09, 95% CI 1.88-2.35), less education (less than high school graduate vs college graduate, OR=2.21, 95% CI 1.88-2.60), older age (10-year increments, OR=2.11, per 10-year increase in age, 95% CI 2.05-2.18), and presence of left ventricular hypertrophy (LVH, OR=1.29, 95% CI 1.06-1.58) were related to development of cognitive impairment. When LVH was excluded from the model, elevated systolic blood pressure was related to incident cognitive impairment. Conclusions: Total FSRP score, elevated blood pressure, and LVH predict development of clinically significant cognitive dysfunction. Prevention and treatment of high blood pressure may be effective in preserving cognitive health.
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U2 - 10.1212/WNL.0b013e318236ef23
DO - 10.1212/WNL.0b013e318236ef23
M3 - Article
C2 - 22067959
AN - SCOPUS:82955210332
SN - 0028-3878
VL - 77
SP - 1729
EP - 1736
JO - Neurology
JF - Neurology
IS - 19
ER -