title: NT-proBNP and the risk of dementia: a prospective cohort study with 14 years of follow-up.
abstract: BACKGROUND
  Memory disorders and Alzheimer's disease (AD) share the same risk factors with cardiovascular diseases.
  
  
  OBJECTIVE
  We tested whether elevated N-terminal pro-brain natriuretic peptide (NT-proBNP) levels would predict any incident dementia or AD.
  
  
  METHODS
  The association between NT-proBNP and the risk of dementia was evaluated in a total of 7,158 subjects without previous memory disorders in a prospective study with a median follow-up of 13.8 years.
  
  
  RESULTS
  A total of 220 new dementia cases occurred, of which 149 were AD. Baseline logNT-proBNP levels were associated significantly with the risk of dementia in the entire study population (HR 1.32, 95%CI 1.17-1.56, p = 0.001) per 1SD difference, adjusted for multiple cardiovascular risk factors. Integrated discrimination improvement (IDI) and continuous net-reclassification improvement (continuous NRI) were improved in the study population over 40 years of age: continuous NRI was 17.5% (95%CI 4.4-30.6%, p = 0.009) and IDI was 0.005 (95%CI 0.001-0.010, p = 0.021). Regarding AD, the HR for 1SD logNT-proBNP change was 1.23 (95%CI 1.01-1.49, p = 0.040) in the entire study population, but no IDI or continuous NRI improvement was seen.
  
  
  CONCLUSIONS
  NT-proBNP is also an independent risk marker for dementia, and patient discrimination regarding dementia risk could be improved by using it.
authors.affiliation: North Karelia Central Hospital, Joensuu, Finland.
authors.forename: Juho
authors.initials: J
authors.lastname: Tynkkynen
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland Hospital District of North Karelia, Joensuu, Finland.
authors.forename: Tiina
authors.initials: T
authors.lastname: Laatikainen
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Veikko
authors.initials: V
authors.lastname: Salomaa
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Aki S
authors.initials: AS
authors.lastname: Havulinna
authors.affiliation: German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Lübeck/Kiel University Heart Center Hamburg, Department of General and Interventional Cardiology, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Blankenberg
authors.affiliation: German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Lübeck/Kiel University Heart Center Hamburg, Department of General and Interventional Cardiology, Germany.
authors.forename: Tanja
authors.initials: T
authors.lastname: Zeller
authors.affiliation: North Karelia Central Hospital, Joensuu, Finland.
authors.forename: Jussi A
authors.initials: JA
authors.lastname: Hernesniemi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D003704:Dementia / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000378:metabolism*; D010446:Peptide Fragments / Q000378:metabolism*; D016016:Proportional Hazards Models; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Alzheimer's disease; N-terminal pro-BNP; biological marker; dementia; population-based; prospective studies; risk