title: Vitamin K antagonists and cognitive impairment: results from a cross-sectional pilot study among geriatric patients.
abstract: BACKGROUND
  Vitamin K is involved in brain physiology, suggesting that its deficiency induces cognitive decline. Our objective was to determine whether using vitamin K antagonists (VKAs) was associated with cognitive impairment among geriatric patients.
  
  
  METHODS
  Two hundred sixty-seven older patients (mean, 83.4 ± 8.1 years; 56.9% female) were categorized according to cognitive impairment (ie, Mini-Mental State Examination ≤ 25). The regular use of VKAs was sought by questioning the patients, relatives, and family physicians. Age, gender, body mass index, comorbidity burden, mood and executive functioning, history of atrial fibrillation, ischemic stroke, intracranial hemorrhage and transient ischemic attack, use of other anticoagulants and antiplatelet medications, and severe renal failure were used as potential confounders.
  
  
  RESULTS
  Compared with participants without cognitive impairment (n = 70), those with Mini-Mental State Examination ≤ 25 used more frequently VKAs (p = .038). The risk of cognitive impairment was 15% higher with VKAs, specifically with fluindione. Using VKAs was independently associated with cognitive impairment (fully adjusted odds ratio = 17.4 [95% CI: 1.4-224.2], p = .028).
  
  
  CONCLUSIONS
  We found more frequent cognitive impairment associated with the use of VKAs, specifically fluindione, among geriatric patients.
authors.affiliation: Department of Neuroscience, Division of Geriatric Medicine, UPRES EA4638, UNAM, Angers University Hospital, France. Robarts Research Institute, The University of Western Ontario, London, Canada. CeAnnweiler@chu-angers.fr.
authors.forename: Cédric
authors.initials: C
authors.lastname: Annweiler
authors.affiliation: Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Quebec, Canada.
authors.forename: Guylaine
authors.initials: G
authors.lastname: Ferland
authors.affiliation: Centre INSERM U897-Epidemiologie-Biostatistique, ISPED, Université Bordeaux, France. Centre INSERM U897-Epidemiologie-Biostatistique, INSERM, ISPED, Bordeaux, France.
authors.forename: Pascale
authors.initials: P
authors.lastname: Barberger-Gateau
authors.affiliation: Department of Neuroscience, Division of Geriatric Medicine, UPRES EA4638, UNAM, Angers University Hospital, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Brangier
authors.affiliation: Department of Geriatric Medicine, Institut du Vieillissement, University Hospital, INSERM-U1027, Toulouse, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Rolland
authors.affiliation: Department of Neuroscience, Division of Geriatric Medicine, UPRES EA4638, UNAM, Angers University Hospital, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Beauchet
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D000925:Anticoagulants / Q000009:adverse effects; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D003072:Cognition Disorders / Q000139:chemically induced* / Q000150:complications; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D010630:Phenindione / Q000009:adverse effects / Q000031:analogs & derivatives; D010865:Pilot Projects; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D014812:Vitamin K / Q000037:antagonists & inhibitors*
chemical_list: D000925:Anticoagulants; D014812:Vitamin K; D010630:Phenindione; C017673:fluindione
keywords: Cognition; Dementia; Neurobiology; Older adults.; Vitamin K; Vitamin K antagonists