Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
J Gerontol A Biol Sci Med Sci. 2018 May 9;73(6):779-785. doi: 10.1093/gerona/glx138.
Cognitive impairment and decline may signal the increased risk of incident cardiovascular disease (CVD). We examined associations of global cognitive function, as measured by the Modified Mini-Mental State Examination (3MS) and changes in 3MS over time, with incident CVD, individual CVD outcomes, CVD death, and all-cause mortality.
A total of 5,596 women (≥ 60) from the Women's Health Initiative Memory Study free of CVD at baseline were followed for an average of 7.1 years. The 3MS was measured at baseline and annually thereafter. Cox proportional hazards regressions were used to model associations between baseline 3MS and changes in 3MS and time to events.
In the fully-adjusted models for every 5-point lower baseline 3MS score, the risk was 12% greater for incident CVD, 37% for HF, 35% for CVD death, and 24% for all-cause mortality. No significant relationships were found for coronary heart disease (CHD), angina, stroke/transient ischemic attack (TIA), or coronary revascularization. When change in 3MS was added as a time-varying covariate in the fully-adjusted models, for every 1-point/year greater decline in 3MS, the risk was 4% greater for incident CVD, 10% for CHD, 9% for Stroke/TIA, 17% for CVD death, and 13% for all-cause mortality.
In older women free of prevalent CVD at baseline, lower baseline global cognitive function or decline in global cognitive function over time, increased risk of incident CVD, CVD death, and all-cause mortality.
认知障碍和认知能力下降可能预示着心血管疾病（CVD）事件风险增加。我们研究了整体认知功能（通过改良的简易精神状态检查（3MS）测量）与 CVD 事件、个体 CVD 结局、CVD 死亡和全因死亡率之间的关联，以及随时间推移 3MS 的变化。
共有 5596 名（≥60 岁）基线时无 CVD 的妇女参加了妇女健康倡议记忆研究，平均随访 7.1 年。基线时和此后每年测量 3MS。Cox 比例风险回归用于构建基线 3MS 与 3MS 变化和时间至事件之间的关联模型。
在经过充分调整的模型中，每降低 5 分基线 3MS 评分，CVD 事件、心力衰竭（HF）、CVD 死亡和全因死亡率的风险分别增加 12%、37%、35%和 24%。对于冠心病（CHD）、心绞痛、中风/短暂性脑缺血发作（TIA）或冠状动脉血运重建，未发现显著相关性。当 3MS 的变化作为时变协变量添加到充分调整的模型中时，每增加 1 分/年 3MS 的下降，CVD 事件、CHD、中风/TIA、CVD 死亡和全因死亡率的风险分别增加 4%、10%、9%、17%和 13%。
在基线时无明显 CVD 的老年女性中，基线时的整体认知功能较低或随时间推移的整体认知功能下降，与 CVD 事件、CVD 死亡和全因死亡率的风险增加相关。
