Title | Hemostatic factor levels and cognitive decline in older adults: The Cardiovascular Health Study. |
Publication Type | Journal Article |
Year of Publication | 2021 |
Authors | Harrington, LB, Ehlert, AN, Thacker, EL, Jenny, NS, Lopez, O, Cushman, M, Fitzpatrick, A, Mukamal, KJ, Jensen, MK |
Journal | J Thromb Haemost |
Date Published | 2021 Mar 16 |
ISSN | 1538-7836 |
Abstract | <p><b>BACKGROUND: </b>Hemostasis is a key factor in cerebrovascular disease, but the association of hemostatic factors with cognitive decline is unclear.</p><p><b>OBJECTIVE: </b>To prospectively evaluate associations of 20 hemostatic factor levels with changes in cognition during ≥8 years of follow-up in the Cardiovascular Health Study (CHS) of older adults.</p><p><b>METHODS: </b>We included participants of an existing CHS cross-sectional substudy (n = 400) with hemostatic factors measured in 1989-1990. Between 1989-1990 and 1998-1999, cognitive function was measured using the Modified Mini-Mental State Examination (3MSE) and Digit Symbol Substitution Tests. Mixed-effects linear regression models estimated change in cognitive function over time, adjusting for sociodemographic and clinical factors and APOE genotype, using Bonferroni adjustment. We also derived principal components to account for the interrelationship among factors.</p><p><b>RESULTS: </b>Of 20 factors evaluated individually, only higher levels of plasmin-α -antiplasmin complex (PAP), tissue factor pathway inhibitor (TFPI), and lower factor X (FXc) levels were associated with faster cognitive decline, estimated by annual change in 3MSE points (1 standard deviation PAP β = -0.65, 95% confidence interval [CI]: -1.08 to -0.21; TFPI β = -0.55, 95% CI: -0.90 to -0.19; FXc β = 0.52, 95% CI: 0.21-0.84). One of four principal components, loading positively on D-dimer, prothrombin fragment 1.2 (F1.2), and PAP was significantly associated with change in 3MSE.</p><p><b>CONCLUSIONS: </b>Levels of PAP, TPFI, and FXc and a combination of factors driven by PAP, D-dimer, and F1.2 were associated with cognitive decline. Whether these findings can be used to improve dementia prevention or prediction requires further study.</p> |
DOI | 10.1111/jth.15300 |
Alternate Journal | J Thromb Haemost |
PubMed ID | 33725412 |
Grant List | U01HL080295 / HL / NHLBI NIH HHS / United States R01NS089638 / NS / NINDS NIH HHS / United States N01HC85081 / HL / NHLBI NIH HHS / United States N01HC85083 / HL / NHLBI NIH HHS / United States K01HL139997 / HL / NHLBI NIH HHS / United States N01HC85082 / HL / NHLBI NIH HHS / United States K01 HL139997 / HL / NHLBI NIH HHS / United States HHSN268201200036C / HL / NHLBI NIH HHS / United States R01AG15928 / AG / NIA NIH HHS / United States HHSN268200800007C / HL / NHLBI NIH HHS / United States R01AG023629 / AG / NIA NIH HHS / United States R01HL046696 / HL / NHLBI NIH HHS / United States U01HL130114 / HL / NHLBI NIH HHS / United States N01HC85080 / HL / NHLBI NIH HHS / United States T32HL098048 / HL / NHLBI NIH HHS / United States HHSN268201800001C / HL / NHLBI NIH HHS / United States R01AG20098 / AG / NIA NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States |