Mini-Mental State Examination score and B-type natriuretic peptide as predictors of cardiovascular and total mortality in an elderly general population.
INTRODUCTION. The aim of the present study was to examine the power of B-type natriuretic peptide (BNP) and mild cognitive impairment as independent predictors of total and cardiovascular mortality in combination with established cardiovascular risk markers in an elderly general population without severe cognitive impairment. METHODS. A total of 499 individuals, aged more than 75 years, were examined and followed up for a median of 7.9 years in a prospective population-based stratified cohort study carried out in eastern Finland. The Cox proportional hazards regression model was used to determine the impact of multiple factors on total and cardiovascular mortality. RESULTS. In a multivariable model including established cardiovascular risk factors and conditions, both continuous BNP (adjusted hazard ratio (HR) 1.44 for a 1-SD change; 95% confidence interval (CI) 1.22-1.77; P < 0.001) and continuous MMSE score (HR 0.81 for a 1-SD change; 95% CI 0.70-0.94; P = 0.007) were independently associated with all-cause mortality. In a multivariable model, BNP remained a significant predictor of cardiovascular mortality, while MMSE score lost its significance. CONCLUSIONS. BNP, a measure of cardiovascular burden, and MMSE score 18-23, an indicator of mild cognitive impairment, are both independent predictors of total mortality. BNP and MMSE score may potentially be useful in screening elderly patients for elevated risk of mortality.
Department of Internal Medicine, Päijät-Häme Central Hospital, Lahti, Finland. tuomas.kerola@phsotey.fi
Tuomas
T
Kerola
Matti
M
Hiltunen
Raimo
R
Kettunen
Sirpa
S
Hartikainen
Raimo
R
Sulkava
Olli
O
Vuolteenaho
Tuomo
T
Nieminen
D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality*; D003072:Cognition Disorders / Q000097:blood / Q000175:diagnosis*; D060825:Cognitive Dysfunction / Q000097:blood / Q000175:diagnosis; D003704:Dementia / Q000097:blood / Q000175:diagnosis*; D005260:Female; D005387:Finland / Q000453:epidemiology; D015577:Geriatric Assessment; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality; D006801:Humans; D008297:Male; D009026:Mortality; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies
D020097:Natriuretic Peptide, Brain