title: Vascular risk factors and cognitive impairment in a stroke-free cohort.
abstract: 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.
authors: Department of Psychiatry, Indiana University School of Medicine, 1111 W. 10th Street, Suite PB 218A, Indianapolis, IN 46202, USA. funverza@iupui.edu
authors: F W
authors: FW
authors: Unverzagt
authors: L A
authors: LA
authors: McClure
authors: V G
authors: VG
authors: Wadley
authors: N S
authors: NS
authors: Jenny
authors: R C
authors: RC
authors: Go
authors: M
authors: M
authors: Cushman
authors: B M
authors: BM
authors: Kissela
authors: B J
authors: BJ
authors: Kelley
authors: R
authors: R
authors: Kennedy
authors: C S
authors: CS
authors: Moy
authors: V
authors: V
authors: Howard
authors: G
authors: G
authors: Howard
mesh_terms: D000368:Aged; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke