School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.
School of Public Health, Curtin University, Bentley, Western Australia, Australia.
Alzheimers Dement. 2023 Aug;19(8):3670-3678. doi: 10.1002/alz.13006. Epub 2023 Mar 1.
Cardiovascular disease (CVD) is a recognized risk factor for dementia. Here we determined the extent to which an incident CVD event modifies the trajectory of cognitive function and risk of dementia.
19,114 adults (65+) without CVD or dementia were followed prospectively over 9 years. Incident CVD (fatal coronary heart disease, nonfatal myocardial infarction [MI], stroke, hospitalization for heart failure) and dementia (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria) were adjudicated by experts.
Nine hundred twenty-two participants had incident CVD, and 44 developed dementia after CVD (4.9% vs. 4.4% for participants without CVD). Following a CVD event there was a short-term drop in processing speed (-1.97, 95% confidence interval [CI]: -2.57 to -1.41), but there was no significant association with longer-term processing speed. In contrast, faster declines in trajectories of global function (-0.56, 95% CI: -0.76 to -0.36), episodic memory (-0.10, 95% CI: -0.16 to -0.04), and verbal fluency (-0.19, 95% CI: -0.30 to -0.01) were observed.
Findings highlight the importance of monitoring cognition after a CVD event.
心血管疾病（CVD）是公认的痴呆风险因素。在这里，我们确定了 CVD 事件对认知功能轨迹和痴呆风险的影响程度。
19114 名无 CVD 或痴呆的成年人（65 岁以上）前瞻性随访 9 年。通过专家确定 CVD 事件（致命性冠心病、非致命性心肌梗死[MI]、中风、心力衰竭住院）和痴呆（精神障碍诊断和统计手册，第四版标准）的发生。
922 名参与者发生 CVD，44 名参与者在 CVD 后发生痴呆（CVD 组为 4.9%，无 CVD 组为 4.4%）。CVD 后，处理速度短期下降（-1.97，95%置信区间[CI]：-2.57 至-1.41），但与长期处理速度没有显著关联。相比之下，在整体功能（-0.56，95% CI：-0.76 至-0.36）、情景记忆（-0.10，95% CI：-0.16 至-0.04）和语言流畅性（-0.19，95% CI：-0.30 至-0.01）轨迹中观察到更快的下降。
研究结果强调了 CVD 事件后监测认知的重要性。
