Rostamian, S., de Haan, S., van der Grond, J., van Buchem, M. A., Ford, I. , Jukema, J. W. and Sabayan, B. (2019) Cognitive function in dementia-free subjects and survival in old Age: The PROSPER study. American Journal of Medicine, 132(12), 1466-1474.e4. (doi: 10.1016/j.amjmed.2019.06.001) (PMID:31228412)
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Abstract
Impairment in domain-specific cognitive function is associated with the increased risk of mortality. We prospectively evaluated the association of executive function and memory with the risk of long-term mortality in dementia-free older subjects. Moreover, we investigated the role of structural brain abnormalities in this association. We included 547 dementia-free participants (mean age 78years, 56.5% male) from the nested magnetic resonance imaging sub-study of the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER). Cox proportional hazard models were used to model 10-year risk of all-cause, cardiovascular and non-cardiovascular mortality in relation to performance in executive function and memory. Moreover, we evaluated the role of total brain parenchymal volume, cerebral blood flow, white matter hyperintensity and the presence of microbleeds and infarcts in the link between cognitive function and mortality. In the multivariable model, lower performance in executive function was associated with greater risk of all-cause (hazard ratio [HR] 1.49, 95% confidence interval [CI] 1.31-1.70), cardiovascular (HR 1.69, 95%CI 1.36-2.11) and non-cardiovascular (HR 1.36, 95%CI 1.15-1.62) mortality. Similarly, poorer performance in memory tests associated with higher risk of all-cause (HR 1.47, 95%CI 1.29-1.68), cardiovascular (HR 1.45, 95%CI 1.15-1.83) and non-cardiovascular (HR 1.49, 95%CI 1.27-1.76) mortality. The associations were similar in subjects with various levels of brain structural abnormalities and cerebral blood flow (all p for interaction >0.05). Poorer performance in both executive function and memory tests associates with all-cause, cardiovascular and non-cardiovascular mortality in elderly individuals. This association is independent of cardiovascular risk factors and diseases, brain structural abnormalities and cerebral blood flow.
| Item Type: | Articles |
|---|---|
| Additional Information: | The original PROSPER clinical trial was founded by a grant from Bristol-Myers Squibb. |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Ford, Professor Ian |
| Authors: | Rostamian, S., de Haan, S., van der Grond, J., van Buchem, M. A., Ford, I., Jukema, J. W., and Sabayan, B. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre |
| Journal Name: | American Journal of Medicine |
| Publisher: | Elsevier |
| ISSN: | 0002-9343 |
| ISSN (Online): | 0002-9343 |
| Published Online: | 20 June 2019 |
| Copyright Holders: | Copyright © 2019 Elsevier Inc. |
| First Published: | First published in American Journal of Medicine 132(12):1466-1474.e4 |
| Publisher Policy: | Reproduced in accordance with the publisher copyright policy |
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