title: Cardiovascular disease and cognitive decline in postmenopausal women: results from the Women's Health Initiative Memory Study.
abstract: BACKGROUND
  Data on cardiovascular diseases (CVD) and cognitive decline are conflicting. Our objective was to investigate if CVD is associated with an increased risk for cognitive decline and to examine whether hypertension, diabetes, or adiposity modify the effect of CVD on cognitive functioning.
  
  
  RESULTS
  Prospective follow-up of 6455 cognitively intact, postmenopausal women aged 65 to 79 years old enrolled in the Women's Health Initiative Memory Study (WHIMS). CVD was determined by self-report. For cognitive decline, we assessed the incidence of mild cognitive impairment (MCI) or probable dementia (PD) via modified mini-mental state examination (3 MS) score, neurocognitive, and neuropsychiatric examinations. The median follow-up was 8.4 years. Women with CVD tended to be at increased risk for cognitive decline compared with those free of CVD (hazard ratio [HR], 1.29; 95% CI: 1.00, 1.67). Women with myocardial infarction or other vascular disease were at highest risk (HR, 2.10; 95% CI: 1.40, 3.15 or HR, 1.97; 95% CI: 1.34, 2.87). Angina pectoris was moderately associated with cognitive decline (HR 1.45; 95% CI: 1.05, 2.01) whereas no significant relationships were found for atrial fibrillation or heart failure. Hypertension and diabetes increased the risk for cognitive decline in women without CVD. Diabetes tended to elevate the risk for MCI/PD in women with CVD. No significant trend was seen for adiposity.
  
  
  CONCLUSIONS
  CVD is associated with cognitive decline in elderly postmenopausal women. Hypertension and diabetes, but not adiposity, are associated with a higher risk for cognitive decline. More research is warranted on the potential of CVD prevention for preserving cognitive functioning.
authors.affiliation: Department of Internal Medicine I, Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Bavaria, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Haring
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Leng
authors.forename: Jennifer
authors.initials: J
authors.lastname: Robinson
authors.forename: Karen C
authors.initials: KC
authors.lastname: Johnson
authors.forename: Rebecca D
authors.initials: RD
authors.lastname: Jackson
authors.forename: Rebecca
authors.initials: R
authors.lastname: Beyth
authors.forename: Jean
authors.initials: J
authors.lastname: Wactawski-Wende
authors.forename: Moritz Wyler
authors.initials: MW
authors.lastname: von Ballmoos
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Goveas
authors.forename: Lewis H
authors.initials: LH
authors.lastname: Kuller
authors.forename: Sylvia
authors.initials: S
authors.lastname: Wassertheil-Smoller
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D060825:Cognitive Dysfunction / Q000453:epidemiology*; D003704:Dementia / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D009203:Myocardial Infarction / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology; D017698:Postmenopause; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D014652:Vascular Diseases / Q000453:epidemiology
keywords: cardiovascular diseases; cognitive decline; postmenopausal women