Cardiac disease associated with increased risk of nonamnestic cognitive impairment: stronger effect on women.
OBJECTIVE
To investigate the association of cardiac disease with amnestic and nonamnestic mild cognitive impairment (aMCI and naMCI, respectively). Nonamnestic mild cognitive impairment, a putative precursor of vascular and other non-Alzheimer dementias, is hypothesized to have a vascular etiology.


METHODS
A prospective, population-based, cohort study with a median 4.0 years of follow-up.


METHODS
Olmsted County, Minnesota.


METHODS
A total of 2719 participants were evaluated at baseline and every 15 months using the Clinical Dementia Rating scale, a neurological evaluation, and neuropsychological testing. A diagnosis of normal cognition, MCI, or dementia was made by consensus. Cardiac disease at baseline was assessed from the participant's medical records.


METHODS
Incident MCI, aMCI, or naMCI.


RESULTS
Of 1450 participants without MCI or dementia at baseline, 366 developed MCI. Cardiac disease was associated with an increased risk of naMCI (hazard ratio, 1.77 [95% CI, 1.16-2.72]). However, the association varied by sex (P = .02 for interaction). Cardiac disease was associated with an increased risk of naMCI (hazard ratio, 3.07 [95% CI, 1.58-5.99]) for women but not for men (hazard ratio, 1.16 [95% CI, 0.68-1.99]). Cardiac disease was not associated with any type of MCI or with aMCI.


CONCLUSIONS
Cardiac disease is an independent risk factor for naMCI; within-sex comparisons showed a stronger association for women. Prevention and management of cardiac disease and vascular risk factors may reduce the risk of naMCI.
Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. roberts.rosebud@mayo.edu
Rosebud O
RO
Roberts
Yonas E
YE
Geda
David S
DS
Knopman
Ruth H
RH
Cha
V Shane
VS
Pankratz
Bradley F
BF
Boeve
Eric G
EG
Tangalos
Robert J
RJ
Ivnik
Michelle M
MM
Mielke
Ronald C
RC
Petersen
D000368:Aged; D000369:Aged, 80 and over; D000647:Amnesia; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011159:Population Surveillance / Q000379:methods; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors