Abstract 1680: Elevated NT-proBNP Levels Are Associated With Poor Cognitive Function in Apparently Healthy Older Adults: Results From the Rancho Bernardo Study
Introduction: Natriuretic peptides (NPs) have prognostic value across a wide spectrum of cardiovascular diseases (CVDs) and can predict cognitive decline in patients with CVD even in the absence of a prior stroke. However, little is known about the association of NPs with cognitive function in apparently healthy populations. Cognitive impairment can precede overt CVD, and since NPs can predict incident CVD, it is plausible that NPs may be associated with cognitive impairment early in the disease process. The purpose of this study was to assess the association between N-terminal pro B-type NP (NT-proBNP) levels and cognitive function in a population of apparently healthy older community-dwelling adults in the Rancho Bernardo Study.
Methods: Of the 1096 participants attending the 1997–99 Rancho Bernardo study visit, 950 had both NT-proBNP levels measured and cognitive function tested. Mini Mental State Exam, Trail-Making Test B, and Category Fluency tests were performed. Participants were classified by NT-proBNP level into “Low” (<450 pg/ml, n=752) and “High” (≥450 pg/ml, n=198) groups. Logistic regression analysis was used to determine the association of high NT-proBNP with poor performance on each cognitive function test, as defined using pre-specified binary cut-points.
Results: Participants with high NT-proBNP levels were older (83 vs. 75 years, p<0.001), had higher systolic blood pressure (147 mmHg vs. 136 mmHg, p<0.001), and had a higher prevalence of prior myocardial infarction (26% vs. 8%, p<0.001) and prior stroke (11% vs. 5%, p=0.001). After adjusting for age, education, body mass index, exercise, alcohol use, and smoking, elevated NT-proBNP levels were independently associated with poor cognitive performance, even after excluding participants with prior stroke (Table⇓).
Conclusions: NT-proBNP levels are strongly and independently associated with poor cognitive function in a population of apparently healthy older community-dwelling adults.
This research has received full or partial funding support from the American Heart Association, Western States Affiliate (California, Nevada & Utah).