Cardiovascular disease and cognitive decline in postmenopausal women: results from the Women's Health Initiative Memory Study.
Cardiovascular disease and cognitive decline in postmenopausal women: results from the Women's Health Initiative Memory Study.
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DOI：
10.1161/jaha.113.000369
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发表时间：
2013-12-18
影响因子：
5.4
通讯作者：
Wassertheil-Smoller S
中科院分区：
文献类型：
--
作者：
Haring B;Leng X;Robinson J;Johnson KC;Jackson RD;Beyth R;Wactawski-Wende J;von Ballmoos MW;Goveas JS;Kuller LH;Wassertheil-Smoller S
关于心血管疾病（CVD）和认知能力下降的数据相互矛盾。我们的目的是调查CVD是否与认知功能下降的风险增加有关，并检查高血压、糖尿病或肥胖是否会改变CVD对认知功能的影响。前瞻性随访6455名年龄在65至79岁之间的认知完整的绝经后女性，这些女性参加了女性健康倡议记忆研究（WHIMS）。CVD通过自我报告确定。对于认知下降，我们通过改良的简易精神状态检查（3 MS）评分、神经认知和神经精神检查评估了轻度认知障碍（MCI）或可能痴呆（PD）的发生率。中位随访时间为8.4年。与未患CVD的女性相比，患有CVD的女性发生认知功能下降的风险往往增加（风险比[HR]，1.29; 95% CI：1.00，1.67）。患有心肌梗死或其他血管疾病的女性风险最高（HR，2.10; 95% CI：1.40，3.15或HR，1.97; 95% CI：1.34，2.87）。心绞痛与认知功能下降中度相关（HR 1.45; 95% CI：1.05，2.01），而与房颤或心力衰竭无显著相关性。高血压和糖尿病增加了无心血管疾病女性认知能力下降的风险。糖尿病倾向于增加女性心血管疾病患者MCI/PD的风险。未观察到肥胖的显著趋势。CVD与老年绝经后妇女的认知能力下降有关。高血压和糖尿病，而不是肥胖，与认知能力下降的风险较高有关。更多的研究是必要的CVD预防保护认知功能的潜力。
Data on cardiovascular diseases (CVD) and cognitive decline are conflicting. Our objective was to investigate if CVD is associated with an increased risk for cognitive decline and to examine whether hypertension, diabetes, or adiposity modify the effect of CVD on cognitive functioning. Prospective follow‐up of 6455 cognitively intact, postmenopausal women aged 65 to 79 years old enrolled in the Women's Health Initiative Memory Study (WHIMS). CVD was determined by self‐report. For cognitive decline, we assessed the incidence of mild cognitive impairment (MCI) or probable dementia (PD) via modified mini‐mental state examination (3 MS) score, neurocognitive, and neuropsychiatric examinations. The median follow‐up was 8.4 years. Women with CVD tended to be at increased risk for cognitive decline compared with those free of CVD (hazard ratio [HR], 1.29; 95% CI: 1.00, 1.67). Women with myocardial infarction or other vascular disease were at highest risk (HR, 2.10; 95% CI: 1.40, 3.15 or HR, 1.97; 95% CI: 1.34, 2.87). Angina pectoris was moderately associated with cognitive decline (HR 1.45; 95% CI: 1.05, 2.01) whereas no significant relationships were found for atrial fibrillation or heart failure. Hypertension and diabetes increased the risk for cognitive decline in women without CVD. Diabetes tended to elevate the risk for MCI/PD in women with CVD. No significant trend was seen for adiposity. CVD is associated with cognitive decline in elderly postmenopausal women. Hypertension and diabetes, but not adiposity, are associated with a higher risk for cognitive decline. More research is warranted on the potential of CVD prevention for preserving cognitive functioning.