Heart failure and risk of dementia in the KUngsholmen project : a six-year follow-up study
Chengxuan Qiu, Bengt Winblad, Alessandra Marengoni, Johan Fastbom, Laura Fratiglioni
Bok Svensk
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| Opplysninger | ABSTRACT: Objectives: Heart failure and dementia are common conditions in old age. Chronic heart failure is reported to be related to cognitive impairment, but little is known regardin the relationship between heart failure end demntia. We sought to investigate wether heart failure was associated wit occurence of Alzheimer`s disease (AD) and dementia. Methods:A standard follow-up procedure was applied twice to community-based dementia-free cohort (n=1301) aged>_75 years over six years to detec incidemt dementia (DSM-III-R criteria). Heart failure at baseline was defined by combining the inpatient register data with the use of cardiac glycosides. Multiple Cox proportional-hazards models were constructed to examine heart failure in association wit AD and dementia. Results: With two follow-up examinations, 350 subjects were diagnosed with dementia, including 260 with AD. At baseline, 284 subjects were identified as having heart failure. Heart failure was associated with multi-adjusted relative risks of 1.7 (95% CI, 1.2-2.4) for AD and 1.5 (95% CI, 1.1-2.0) for dementia. The risk effects were statistically significant for the subgroup of heart failure patients not using antihypertensive drugs, but not for those treated with the drug. Subjects with both heart failure and low diastolic pressure (<70mm Hg) had a higher risk for AD and dementia than those with either of them. No statistical interaction between heart failure, use of antihypertensive drugs, high systolic pressure, and low diastolic pressure was detected. Conclusions: Heart failure is a risk factor for AD and dementia in very old adults. Use of antihypertensive drugs counteracts the risk effect of heart failure on dementia. Heart failure and low diastolic pressure have an additive effect on dementia risk.
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