title: High-sensitivity cardiac troponin T and cognitive function and dementia risk: the atherosclerosis risk in communities study.
abstract: OBJECTIVE
  Clinical cardiovascular disease is a major risk factor for cognitive impairment and dementia. However, less is known about the association of subclinical myocardial damage with cognition and dementia. We sought to examine the associations of high-sensitivity cardiac troponin T (hs-cTnT) with cognition and dementia.
  
  
  RESULTS
  Cross-sectional analysis of cognition (baseline 1996-98) and prospective analysis of dementia (follow-up through 2010) in 9472 participants in the Atherosclerosis Risk in Communities study. High-sensitivity cardiac troponin T was measured using a novel highly sensitive assay with a lower limit of the blank of 3 ng/L. Cognitive function was assessed by three tests: the delayed word recall test (DWRT), the digit symbol substitution test (DSST), and the word fluency test (WFT). Dementia was defined using ICD-9 codes. Linear regression and Cox models were adjusted for traditional cardiovascular risk factors. The mean age of participants was 63 years, 59% were female, 21% were black, and 66% had hs-cTnT ≥3 ng/L. In cross-sectional analyses, higher hs-cTnT was associated with lower scores on the DSST (P-trend < 0.001) and the WFT (P-trend = 0.002), but not on the DWRT (P-trend = 0.089). Over a median of 13 years, there were 455 incident dementia hospitalizations. In prospective analyses, higher baseline concentrations of hs-cTnT were associated with an increased risk for dementia hospitalizations overall (P-trend < 0.001) and for vascular dementia (P-trend = 0.029), but not for Alzheimer's dementia (P-trend = 0.212).
  
  
  CONCLUSIONS
  Elevations in baseline concentrations of hs-cTnT were associated with lower cognitive test scores at baseline and increased dementia hospitalization risk during the follow-up. Our results suggest that subclinical myocardial injury is associated with cognition and dementia.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA achris13@jhmi.edu.
authors.forename: Andrea L C
authors.initials: AL
authors.lastname: Schneider
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Andreea M
authors.initials: AM
authors.lastname: Rawlings
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: A Richey
authors.initials: AR
authors.lastname: Sharrett
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Alonso
authors.affiliation: Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Mosley
authors.affiliation: Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Ron C
authors.initials: RC
authors.lastname: Hoogeveen
authors.affiliation: Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Christie M
authors.initials: CM
authors.lastname: Ballantyne
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Rebecca F
authors.initials: RF
authors.lastname: Gottesman
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Selvin
mesh_terms: D050197:Atherosclerosis / Q000097:blood / Q000150:complications*; D009202:Cardiomyopathies / Q000150:complications; D003072:Cognition Disorders / Q000097:blood / Q000209:etiology*; D003430:Cross-Sectional Studies; D003704:Dementia / Q000097:blood / Q000209:etiology*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011581:Psychological Tests; D012307:Risk Factors; D020107:Troponin T / Q000378:metabolism*
chemical_list: D020107:Troponin T
keywords: Cognition; Dementia; High-sensitivity Troponin T