title: Heart failure and cognitive function in the general population: the Hoorn Study.
abstract: OBJECTIVE
  To examine whether reduced cognitive functioning can be observed in early stages of left ventricular (LV) dysfunction and heart failure.
  
  
  RESULTS
  In 313 individuals aged 59-87 years from the longitudinal non-demented population-based Hoorn Study, echocardiography was performed to measure markers of LV systolic and diastolic function at baseline (2000-01) and follow-up (2005-09), together with standardized physical examinations and brain natriuretic peptide (BNP) measurements. Heart failure was assessed echocardiographically at the follow-up examination only. Cognitive tests for information processing speed, memory, and attention and executive functioning were administered at follow-up. Linear regression analyses showed that baseline markers of LV diastolic function, but not LV systolic function, were associated with lower scores on attention and executive functioning at follow-up. Individuals with higher baseline BNP had lower scores on all three cognitive domains: standardized regression coefficients were -0.16 (-0.26 to -0.05), -0.17 (-0.28 to -0.05), and -0.28 (-0.37 to -0.19). Worse LV systolic and diastolic function at follow-up were associated with a worse performance on attention and executive functioning. Furthermore, individuals with heart failure at follow-up had lower scores on attention and executive functioning: -0.21 (-0.41 to -0.00). Higher BNP at follow-up was also associated with worse attention and executive functioning, even after adjustment for baseline BNP.
  
  
  CONCLUSIONS
  Worse cognitive functioning can already be observed in early stages of LV dysfunction and heart failure. BNP is a target for further investigation as a risk factor for cognitive decline in the general population.
authors: Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, Amsterdam, The Netherlands.
authors: Katja
authors: K
authors: van den Hurk
authors: Yael D
authors: YD
authors: Reijmer
authors: Esther
authors: E
authors: van den Berg
authors: Marjan
authors: M
authors: Alssema
authors: Giel
authors: G
authors: Nijpels
authors: Piet J
authors: PJ
authors: Kostense
authors: Coen D A
authors: CD
authors: Stehouwer
authors: Walter J
authors: WJ
authors: Paulus
authors: Otto
authors: O
authors: Kamp
authors: Jacqueline M
authors: JM
authors: Dekker
authors: Geert Jan
authors: GJ
authors: Biessels
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors