title: Executive function, but not memory, associates with incident coronary heart disease and stroke.
abstract: OBJECTIVE
  To evaluate the association of performance in cognitive domains executive function and memory with incident coronary heart disease and stroke in older participants without dementia.
  
  
  METHODS
  We included 3,926 participants (mean age 75 years, 44% male) at risk for cardiovascular diseases from the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) with Mini-Mental State Examination score ≥24 points. Scores on the Stroop Color-Word Test (selective attention) and the Letter Digit Substitution Test (processing speed) were converted to Z scores and averaged into a composite executive function score. Likewise, scores of the Picture Learning Test (immediate and delayed memory) were transformed into a composite memory score. Associations of executive function and memory were longitudinally assessed with risk of coronary heart disease and stroke using multivariable Cox regression models.
  
  
  RESULTS
  During 3.2 years of follow-up, incidence rates of coronary heart disease and stroke were 30.5 and 12.4 per 1,000 person-years, respectively. In multivariable models, participants in the lowest third of executive function, as compared to participants in the highest third, had 1.85-fold (95% confidence interval [CI] 1.39-2.45) higher risk of coronary heart disease and 1.51-fold (95% CI 0.99-2.30) higher risk of stroke. Participants in the lowest third of memory had no increased risk of coronary heart disease (hazard ratio 0.99, 95% CI 0.74-1.32) or stroke (hazard ratio 0.87, 95% CI 0.57-1.32).
  
  
  CONCLUSIONS
  Lower executive function, but not memory, is associated with higher risk of coronary heart disease and stroke. Lower executive function, as an independent risk indicator, might better reflect brain vascular pathologies.
authors.affiliation: From the Departments of Radiology (S.R., M.A.v.B., B.S.), Gerontology and Geriatrics (S.R., R.G.J.W., S.P.M., B.S., A.J.M.d.C.), and Cardiology (J.W.J.), Leiden University Medical Center, the Netherlands; and the Department of Public Health (R.G.J.W.), Copenhagen University, Denmark.
authors.forename: Somayeh
authors.initials: S
authors.lastname: Rostamian
authors.affiliation: From the Departments of Radiology (S.R., M.A.v.B., B.S.), Gerontology and Geriatrics (S.R., R.G.J.W., S.P.M., B.S., A.J.M.d.C.), and Cardiology (J.W.J.), Leiden University Medical Center, the Netherlands; and the Department of Public Health (R.G.J.W.), Copenhagen University, Denmark.
authors.forename: Mark A
authors.initials: MA
authors.lastname: van Buchem
authors.affiliation: From the Departments of Radiology (S.R., M.A.v.B., B.S.), Gerontology and Geriatrics (S.R., R.G.J.W., S.P.M., B.S., A.J.M.d.C.), and Cardiology (J.W.J.), Leiden University Medical Center, the Netherlands; and the Department of Public Health (R.G.J.W.), Copenhagen University, Denmark.
authors.forename: Rudi G J
authors.initials: RG
authors.lastname: Westendorp
authors.affiliation: From the Departments of Radiology (S.R., M.A.v.B., B.S.), Gerontology and Geriatrics (S.R., R.G.J.W., S.P.M., B.S., A.J.M.d.C.), and Cardiology (J.W.J.), Leiden University Medical Center, the Netherlands; and the Department of Public Health (R.G.J.W.), Copenhagen University, Denmark.
authors.forename: J Wouter
authors.initials: JW
authors.lastname: Jukema
authors.affiliation: From the Departments of Radiology (S.R., M.A.v.B., B.S.), Gerontology and Geriatrics (S.R., R.G.J.W., S.P.M., B.S., A.J.M.d.C.), and Cardiology (J.W.J.), Leiden University Medical Center, the Netherlands; and the Department of Public Health (R.G.J.W.), Copenhagen University, Denmark.
authors.forename: Simon P
authors.initials: SP
authors.lastname: Mooijaart
authors.affiliation: From the Departments of Radiology (S.R., M.A.v.B., B.S.), Gerontology and Geriatrics (S.R., R.G.J.W., S.P.M., B.S., A.J.M.d.C.), and Cardiology (J.W.J.), Leiden University Medical Center, the Netherlands; and the Department of Public Health (R.G.J.W.), Copenhagen University, Denmark. b.sabayan@lumc.nl.
authors.forename: Behnam
authors.initials: B
authors.lastname: Sabayan
authors.affiliation: From the Departments of Radiology (S.R., M.A.v.B., B.S.), Gerontology and Geriatrics (S.R., R.G.J.W., S.P.M., B.S., A.J.M.d.C.), and Cardiology (J.W.J.), Leiden University Medical Center, the Netherlands; and the Department of Public Health (R.G.J.W.), Copenhagen University, Denmark.
authors.forename: Anton J M
authors.initials: AJ
authors.lastname: de Craen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003327:Coronary Disease / Q000453:epidemiology* / Q000523:psychology*; D056344:Executive Function; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008568:Memory; D008609:Mental Status Schedule; D015337:Multicenter Studies as Topic; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D016016:Proportional Hazards Models; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000453:epidemiology* / Q000523:psychology*