title: Left Ventricular Hypertrophy and Cognitive Decline in Old Age.
abstract: Patients with advanced heart failure run a greater risk of dementia. Whether early cardiac structural changes also associate with cognitive decline is yet to be determined.
  
  
  
  We tested whether left ventricular hypertrophy (LVH) derived from electrocardiogram associates with cognitive decline in older subjects at risk of cardiovascular disease.
  
  
  
  We included 4,233 participants (mean age 75.2 years, 47.8% male) from PROSPER (PROspective Study of Pravastatin in the Elderly at Risk). LVH was assessed from baseline electrocardiograms by measuring the Sokolow-Lyon index. Higher levels of Sokolow-Lyon index indicate higher degrees of LVH. Cognitive domains involving selective attention, processing speed, and immediate and delayed memory were measured at baseline and repeated during a mean follow-up of 3.2 years.
  
  
  
  At baseline, LVH was not associated with worse cognitive function. During follow-up, participants with higher levels of LVH had a steeper decline in cognitive function including in selective attention (p = 0.009), processing speed (p = 0.010), immediate memory (p < 0.001), and delayed memory (p = 0.002). These associations were independent of cardiovascular risk factors, co-morbidities, and medications.
  
  
  
  LVH assessed by electrocardiogram associates with steeper decline in cognitive function of older subjects independent of cardiovascular risk factors and co-morbidities. This study provides further evidence on the link between subclinical cardiac structural changes and cognitive decline in older subjects.
authors.affiliation: Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Simin
authors.initials: S
authors.lastname: Mahinrad
authors.affiliation: Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Annelotte E
authors.initials: AE
authors.lastname: Vriend
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: J Wouter
authors.initials: JW
authors.lastname: Jukema
authors.affiliation: Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Diana
authors.initials: D
authors.lastname: van Heemst
authors.affiliation: BHF Glasgow Cardiovascular Research Center, University of Glasgow, Glasgow, UK.
authors.forename: Naveed
authors.initials: N
authors.lastname: Sattar
authors.affiliation: Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Gerard Jan
authors.initials: GJ
authors.lastname: Blauw
authors.affiliation: Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, UK.
authors.forename: Peter W
authors.initials: PW
authors.lastname: Macfarlane
authors.affiliation: Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, UK.
authors.forename: Elaine N
authors.initials: EN
authors.lastname: Clark
authors.affiliation: Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Anton J M
authors.initials: AJM
authors.lastname: de Craen
authors.affiliation: Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands.|Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.|Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Behnam
authors.initials: B
authors.lastname: Sabayan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D060825:Cognitive Dysfunction / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D015331:Cohort Studies; D004562:Electrocardiography; D056344:Executive Function / Q000502:physiology; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications* / Q000453:epidemiology*; D008297:Male; D008568:Memory / Q000502:physiology; D008609:Mental Status Schedule; D015233:Models, Statistical; D009483:Neuropsychological Tests; D013997:Time Factors
keywords: Cardiovascular disease; cognitive function; elderly; left ventricular hypertrophy