title: Incident Heart Failure and Cognitive Decline: The Atherosclerosis Risk in Communities Study.
abstract: BACKGROUND
  Cognitive impairment is found in a significant proportion of patients with heart failure (HF). Although cognitive impairment may be a consequence of HF, early signs of cognitive impairment may also indicate subclinical vascular disease, and thus a risk factor for future cardiovascular events.
  
  
  RESULTS
  The Atherosclerosis Risk in Communities Study is a prospective cohort study of the development of atherosclerosis. Cox proportional hazards regression was used to examine the association between mean 6-year change in cognitive function and incident HF in 7962 white and 1933 African-American men and women aged 46 to 70 years and free of clinical stroke. Scores were obtained for the Delayed Word Recall Test, the Digit Symbol Substitution Test (DSST), and the Word Fluency Test. There was a significantly increased risk of developing HF during the mean 12.6-year follow-up period after adjustment for age, gender, race, and education for those in the quartile with the greatest decline in DSST scores (hazard ratio [HR] = 1.17, P = .009), and in the quartile with the lowest baseline DSST scores (HR = 1.43, P < .001).
  
  
  CONCLUSIONS
  The results suggest that relatively low performance on a test of information processing speed may serve as an indicator of HF risk in middle age.
authors.affiliation: Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas.
authors.forename: Jan
authors.initials: J
authors.lastname: Bressler
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, Minnesota.
authors.forename: David S
authors.initials: DS
authors.lastname: Knopman
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: A Richey
authors.initials: AR
authors.lastname: Sharrett
authors.affiliation: Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Rebecca F
authors.initials: RF
authors.lastname: Gottesman
authors.affiliation: Department of Medicine, Division of Geriatrics, University of Mississippi Medical Center, Jackson, Mississippi.
authors.forename: Alan
authors.initials: A
authors.lastname: Penman
authors.affiliation: Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
authors.forename: Patricia P
authors.initials: PP
authors.lastname: Chang
authors.affiliation: Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina.
authors.forename: Wayne D
authors.initials: WD
authors.lastname: Rosamond
authors.affiliation: Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas; Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas.
authors.forename: Eric
authors.initials: E
authors.lastname: Boerwinkle
authors.affiliation: Department of Medicine, Division of Geriatrics, University of Mississippi Medical Center, Jackson, Mississippi. Electronic address: tmosley@umc.edu.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Mosley
mesh_terms: D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000150:complications* / Q000453:epidemiology; D003071:Cognition / Q000502:physiology*; D060825:Cognitive Dysfunction / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012111:Residence Characteristics; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology
keywords: Epidemiology; cognition