title: N-terminal pro-brain natriuretic peptide and cognitive decline in older adults at high cardiovascular risk.
abstract: OBJECTIVE
  Elevated levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) are associated with cognitive impairment, which might be explained by cardiovascular diseases or risk factors. The aim of this study was to investigate the association of NT-proBNP with cognitive function and decline in older adults at high risk of cardiovascular disease.
  
  
  METHODS
  We studied 5,205 men and women (mean age = 75 years) who were recruited into the PROspective Study of Pravastatin in the Elderly at Risk. All participants had pre-existing cardiovascular disease or risk factors thereof. Four domains of cognitive function were tested at baseline and repeated during a follow-up period of 3.2 years.
  
  
  RESULTS
  Participants with higher NT-proBNP (≥450ng/l) had worse baseline cognitive function, including reaction time (mean difference high vs low group = 3.07 seconds, 95% confidence interval [CI] = 0.83 to 5.32), processing speed (-1.02 digits coded, 95% CI = -1.65 to -0.39), and immediate memory (-0.13 pictures remembered, 95% CI = -0.29 to 0.04). There was no significant difference in delayed memory (-0.14, 95% CI = -0.38 to 0.10) between the NT-proBNP groups. Participants with higher NT-proBNP had a steeper cognitive decline, including reaction time (mean annual change high vs low group = 0.60 seconds, 95% CI = 0.14 to 1.07), processing speed (-0.15 digits coded, 95% CI = -0.25 to -0.05), immediate memory (-0.05 pictures remembered, 95% CI = -0.09 to 0.00), and delayed memory (-0.05 pictures remembered, 95% CI = -0.11 to 0.01). Associations were independent of cardiovascular diseases and risks.
  
  
  CONCLUSIONS
  Higher NT-proBNP associates with worse cognitive function and steeper cognitive decline, independent of cardiovascular diseases and risks. Further studies to unravel the underlying mechanisms are warranted.
authors.affiliation: Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands; Netherlands Consortium for Healthy Ageing, Leiden, the Netherlands.
authors.forename: Liselotte W
authors.initials: LW
authors.lastname: Wijsman
authors.forename: Behnam
authors.initials: B
authors.lastname: Sabayan
authors.forename: Peter
authors.initials: P
authors.lastname: van Vliet
authors.forename: Stella
authors.initials: S
authors.lastname: Trompet
authors.forename: Wouter
authors.initials: W
authors.lastname: de Ruijter
authors.forename: Rosalinde K E
authors.initials: RK
authors.lastname: Poortvliet
authors.forename: Petra G
authors.initials: PG
authors.lastname: van Peet
authors.forename: Jacobijn
authors.initials: J
authors.lastname: Gussekloo
authors.forename: J Wouter
authors.initials: JW
authors.lastname: Jukema
authors.forename: David J
authors.initials: DJ
authors.lastname: Stott
authors.forename: Naveed
authors.initials: N
authors.lastname: Sattar
authors.forename: Ian
authors.initials: I
authors.lastname: Ford
authors.forename: Rudi G J
authors.initials: RG
authors.lastname: Westendorp
authors.forename: Anton J M
authors.initials: AJ
authors.lastname: de Craen
authors.forename: Simon P
authors.initials: SP
authors.lastname: Mooijaart
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000097:blood*; D003072:Cognition Disorders / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D016032:Randomized Controlled Trials as Topic; D012306:Risk
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain