The Effect of Cardiovascular Stress on Cognition and Mortality : Studies on B-type Natriuretic Peptide amongst the Elderly Population
Year: 2014
Type: dissertation
Study design: Observational Study
Abstract: Traditional cardiovascular risk factors in midlife are known to associate with memory illness in later life. In late-life, however, this association is less clear. Recognition of new modifiable cardiovascular risk factors with prognostic capacity on memory illness are needed in the older population. In recent years, the association between natriuretic peptides, biomarkers of direct cardiovascular stress, and cognitive decline has been addressed within a few studies. Severe cognitive decline and depressive symptoms have been linked to increased mortality amongst the elderly. The impact of mild cognitive decline on mortality has been less clear. Increased cardiovascular morbidity, mood disorders and memory illnesses are conditions that may overlap in older people. The aim of this study was to investigate the impact of B-type natriuretic peptide (BNP) a marker of cardiovascular stress on mortality, together with the Mini Mental State Examination Score (MMSE) and depressive symptoms in combination with established cardiovascular risk factors in an older general population. Another aim of this study was to investigate how the prognostic capacity of BNP on memory illness varies with aging, and to examine the relationship between BNP and the severity of memory illness. This study was based on the Kuopio 75+ health study, a prospective age-stratified cohort study with 601 individuals aged 75 years or over. The participants were examined at the entry of the study and during a five-year follow-up visit. Clinical examination including assessment of cognitive function and laboratory count including BNP were performed. Mortality data were obtained from Statistics Finland. BNP was a strong predictor of all-cause and cardiovascular mortality when examined together with MMSE score or depressive symptoms. An MMSE score of 18-23 was a predictor of total rather than cardiovascular mortality. Depressive symptoms had no significant independent predictive value on total or cardiovascular mortality. BNP had prognostic capacity on memory illness in the 75-78 years age-group, but not in older age-groups. BNP was also associated with mild memory illness, but this association was lost in the more severe forms of memory illness. In conclusion, BNP showed good performance as a predictor of all-cause and cardiovascular mortality when tested together with MMSE score or depressive symptoms in combination with established cardiovascular risk factors in the elderly population. The relationship between BNP and memory illness varies by age and progression of disorder, as the previously found link between BNP and memory illness is present only in the population aged under 79 years and in mild stages of disorder. More information is needed especially for recognizing prognostic tools for the identification of older individuals at elevated risk of mortality and developing a memory illness.
Source: Työväentutkimus Vuosikirja
Author: Matti Hiltunen
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W1539984196