title: Risk of dementia and death in the long-term follow-up of the Pittsburgh Cardiovascular Health Study-Cognition Study.
abstract: BACKGROUND
  Increasing life expectancy has resulted in a larger population of older individuals at risk of dementia.
  
  
  METHODS
  The Cardiovascular Health Study-Cognition Study followed 532 participants from 1998-99 (mean age 79) to 2013 (mean age 93) for death and dementia.
  
  
  RESULTS
  Risk of death was determined by extent of coronary artery calcium, high-sensitivity cardiac troponin, brain natriuretic peptide, and white matter grade. Significant predictors of dementia were age, apolipoprotein-E4, vocabulary raw score, hippocampal volume, ventricular size, cognitive performance, and number of blocks walked. By 2013, 160 of 532 were alive, including 19 cognitively normal. Those with normal cognition had higher grade education, better cognition test scores, greater hippocampal volume, faster gait speed, and number of blocks walked as compared with survivors who were demented.
  
  
  CONCLUSIONS
  Few survived free of dementia and disability. Prevention and delay of cognitive decline for this older population is an imperative.
authors.affiliation: Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA. Electronic address: kullerl@edc.pitt.edu.
authors.forename: Lewis H
authors.initials: LH
authors.lastname: Kuller
authors.affiliation: Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA; Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Oscar L
authors.initials: OL
authors.lastname: Lopez
authors.affiliation: Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA; Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA; Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: James T
authors.initials: JT
authors.lastname: Becker
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Yuefang
authors.initials: Y
authors.lastname: Chang
authors.affiliation: Department of Epidemiology, Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Anne B
authors.initials: AB
authors.lastname: Newman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D053327:Apolipoprotein E4 / Q000235:genetics; D044383:Black People / Q000235:genetics; D001921:Brain / Q000033:anatomy & histology* / Q000473:pathology; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003071:Cognition / Q000502:physiology*; D003704:Dementia / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D010414:Pennsylvania / Q000453:epidemiology; D012307:Risk Factors; D016138:Walking / Q000502:physiology; D044465:White People / Q000235:genetics; D001741:Black or African American
chemical_list: D053327:Apolipoprotein E4
keywords: Aging; Cognition; Dementia; Epidemiology; MRI