Abstract MP25: Coronary Heart Disease is Associated with Cognitive Decline in Postmenopausal Women: Results from the Women’s Health Initiative Memory Study
Background Although several cardiovascular risk factors have been associated with an increased risk for cognitive decline, few data are available on the risk of cardiovascular disease (CVD) for the development of probable dementia (PD) or mild cognitive impairment (MCI) in those with existing clinical CVD or coronary heart disease (CHD).
Objective To determine whether the presence of clinical CVD (defined as a composite of peripheral vascular disease, CHD, coronary bypass surgery, angioplasty, congestive heart failure, angina pectoris, carotid endarterectomy and atrial fibrillation at enrollment) or CHD are associated with an increased risk for PD and MCI in postmenopausal women.
Study population Prospective follow-up of over 6455 cognitively intact postmenopausal women aged 65-79 years at baseline enrolled in the WHI Hormone Trials.
Main Outcome Measure Incidence of PD and MCI was identified and centrally adjudicated in all women in the hormone therapy clinical trials of WHI. Global cognitive function was assessed via modified mini-mental state examination (3MS) score, neurocognitive and neuropsychiatric examinations.
Results Over 6 years of follow-up incidence rates for dementia or mild cognitive impairment were higher among women with CHD at baseline (20/1000 person years) compared to those without CHD (8.1/1000 person years). Incidence rates for those with CVD at baseline also were higher than for those free of CVD, though less markedly so (12.7 vs. 7.8/1000 person years). The multivariate-adjusted hazard ratios for women with baseline CHD compared to those free of CHD were: 2.18 (95% CI: 1.19, 3.99) for dementia, 2.56 (95% CI: 1.64, 4.01) for MCI, and 2.10 (95% CI: 1.40, 3.15) for the composite of MCI or dementia.
Conclusions Coronary heart disease is significantly associated with the development of mild cognitive impairment or dementia over time in older, initially cognitively intact, postmenopausal women. The broader category of cardiovascular disease also increases risk of cognitive decline.
- © 2013 by American Heart Association, Inc.