Title | Trajectory of Cognitive Function After Incident Heart Failure. |
Publication Type | Journal Article |
Year of Publication | 2024 |
Authors | Shore, S, Li, H, Zhang, M, Whitney, R, Gross, AL, Bhatt, AS, Nallamothu, BK, Giordani, B, Briceño, EM, Sussman, JB, Gutierrez, J, Yaffe, K, Griswold, M, Johansen, MC, Lopez, OL, Gottesman, RF, Sidney, S, Heckbert, SR, Rundek, T, Hughes, TM, Longstreth, WT, Levine, DA |
Journal | medRxiv |
Date Published | 2024 Feb 11 |
Abstract | <p><b>BACKGROUND: </b>The size/magnitude of cognitive changes after incident heart failure (HF) are unclear. We assessed whether incident HF is associated with changes in cognitive function after accounting for pre-HF cognitive trajectories and known determinants of cognition.</p><p><b>METHODS: </b>This pooled cohort study included adults without HF, stroke, or dementia from six US population-based cohort studies from 1971-2019: Atherosclerosis Risk in Communities Study, Coronary Artery Risk Development in Young Adults Study, Cardiovascular Health Study, Framingham Offspring Study, Multi-Ethnic Study of Atherosclerosis, and Northern Manhattan Study. Linear mixed-effects models estimated changes in cognition at the time of HF (change in the intercept) and the rate of cognitive change over the years after HF (change in the slope), controlling for pre-HF cognitive trajectories and participant factors. Change in global cognition was the primary outcome. Change in executive function and memory were secondary outcomes. Cognitive outcomes were standardized to a -score metric (mean [SD], 50 [10]); a 1-point difference represented a 0.1-SD difference in cognition.</p><p><b>RESULTS: </b>The study included 29,614 adults (mean [SD] age was 61.1 [10.5] years, 55% female, 70.3% White, 22.2% Black 7.5% Hispanic). During a median follow-up of 6.6 (Q1-Q3: 5-19.8) years, 1,407 (4.7%) adults developed incident HF. Incident HF was associated with an acute decrease in global cognition (-1.08 points; 95% CI -1.36, -0.80) and executive function (-0.65 points; 95% CI -0.96, -0.34) but not memory (-0.51 points; 95% CI -1.37, 0.35) at the time of the event. Greater acute decreases in global cognition after HF were seen in those with older age, female sex and White race. Individuals with incident HF, compared to HF-free individuals, demonstrated faster declines in global cognition (-0.15 points per year; 95% CI, -0.21, -0.09) and executive function (-0.16 points per year; 95% CI -0.23, -0.09) but not memory ( -0.11 points per year; 95% CI -0.26, 0.04) compared with pre-HF slopes.</p><p><b>CONCLUSIONS: </b>In this pooled cohort study, incident HF was associated with an acute decrease in global cognition and executive function at the time of the event and faster declines in global cognition and executive function over the following years.</p> |
DOI | 10.1101/2024.02.09.24302608 |
Alternate Journal | medRxiv |
PubMed ID | 38370803 |
PubMed Central ID | PMC10871464 |
Grant List | P30 AG053760 / AG / NIA NIH HHS / United States N01HC95160 / HL / NHLBI NIH HHS / United States N01HC95168 / HL / NHLBI NIH HHS / United States HHSN268201800007I / HL / NHLBI NIH HHS / United States N01HC95165 / HL / NHLBI NIH HHS / United States N01HC85083 / HL / NHLBI NIH HHS / United States R01 AG051827 / AG / NIA NIH HHS / United States R01 HL127659 / HL / NHLBI NIH HHS / United States N01HC85081 / HL / NHLBI NIH HHS / United States 75N92020D00002 / HL / NHLBI NIH HHS / United States HHSN268201500003C / HL / NHLBI NIH HHS / United States U01 HL096812 / HL / NHLBI NIH HHS / United States 75N92020D00005 / HL / NHLBI NIH HHS / United States R01 AG015928 / AG / NIA NIH HHS / United States N01HC95163 / HL / NHLBI NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States HHSN268201800004I / HL / NHLBI NIH HHS / United States 75N92022D00002 / HL / NHLBI NIH HHS / United States HHSN268201500001C / HL / NHLBI NIH HHS / United States UL1 TR001079 / TR / NCATS NIH HHS / United States U01 HL096917 / HL / NHLBI NIH HHS / United States K01 AG050699 / AG / NIA NIH HHS / United States U01 HL130114 / HL / NHLBI NIH HHS / United States HHSN268200800007C / HL / NHLBI NIH HHS / United States 75N92020D00001 / HL / NHLBI NIH HHS / United States N01HC95169 / HL / NHLBI NIH HHS / United States U01 HL096902 / HL / NHLBI NIH HHS / United States P30 AG024824 / AG / NIA NIH HHS / United States R01 NS102715 / NS / NINDS NIH HHS / United States N01HC95164 / HL / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01HC95162 / HL / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States 75N92020D00003 / HL / NHLBI NIH HHS / United States 75N92022D00004 / HL / NHLBI NIH HHS / United States HHSN268201800003I / HL / NHLBI NIH HHS / United States HHSN268201200036C / HL / NHLBI NIH HHS / United States HHSN268201800001C / HL / NHLBI NIH HHS / United States N01HC95159 / HL / NHLBI NIH HHS / United States HHSN268201500001I / HL / NHLBI NIH HHS / United States N01HC95161 / HL / NHLBI NIH HHS / United States R01 AG054069 / AG / NIA NIH HHS / United States UL1 TR001420 / TR / NCATS NIH HHS / United States 75N92020D00004 / HL / NHLBI NIH HHS / United States U01 HL096814 / HL / NHLBI NIH HHS / United States 75N92020D00007 / HL / NHLBI NIH HHS / United States R01 NS029993 / NS / NINDS NIH HHS / United States K23 NS112459 / NS / NINDS NIH HHS / United States 75N92022D00003 / HL / NHLBI NIH HHS / United States HHSN268201500003I / HL / NHLBI NIH HHS / United States 75N92021D00006 / HL / NHLBI NIH HHS / United States 75N92022D00005 / HL / NHLBI NIH HHS / United States R01 AG020098 / AG / NIA NIH HHS / United States N01HC85082 / HL / NHLBI NIH HHS / United States N01HC95167 / HL / NHLBI NIH HHS / United States RF1 AG068410 / AG / NIA NIH HHS / United States U01 HL096899 / HL / NHLBI NIH HHS / United States UL1 TR000040 / TR / NCATS NIH HHS / United States 75N92020D00006 / HL / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01HC95166 / HL / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States HHSN268201800005I / HL / NHLBI NIH HHS / United States N01HC85080 / HL / NHLBI NIH HHS / United States 75N92022D00001 / HL / NHLBI NIH HHS / United States HHSN268201800006I / HL / NHLBI NIH HHS / United States |