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Published on: February 14, 2014
Left Ventricular Hypertrophy and Cognitive Decline in Old Age
Simin Mahinrad1, Annelotte E Vriend1, J Wouter Jukema2
1Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands.
Insights
Left ventricular hypertrophy (LVH), a heart condition, is linked to faster cognitive decline in older adults. This association persists even when considering other health issues, highlighting a connection between heart health and brain function.
Area of Science:
- Cardiology
- Neurology
- Geriatrics
Background:
- Advanced heart failure increases dementia risk.
- Early cardiac structural changes' link to cognitive decline is unclear.
Purpose of the Study:
- To investigate if left ventricular hypertrophy (LVH) from electrocardiograms (ECG) associates with cognitive decline in older adults at cardiovascular risk.
Main Methods:
- 4,233 participants (mean age 75.2) from the PROSPER study.
- LVH assessed via Sokolow-Lyon index on baseline ECGs.
- Cognitive function (attention, processing speed, memory) measured at baseline and over 3.2 years.
Main Results:
- No baseline association between LVH and cognitive function.
- Higher LVH levels correlated with steeper decline in attention, processing speed, and immediate/delayed memory during follow-up.
- Associations remained significant after adjusting for cardiovascular risk factors, comorbidities, and medications.
Conclusions:
- ECG-assessed LVH is linked to accelerated cognitive decline in older adults.
- This relationship is independent of traditional cardiovascular risk factors and comorbidities.
- Subclinical cardiac structural changes may contribute to cognitive decline in aging populations.
Background:
Patients with advanced heart failure run a greater risk of dementia. Whether early cardiac structural changes also associate with cognitive decline is yet to be determined.
Objective:
We tested whether left ventricular hypertrophy (LVH) derived from electrocardiogram associates with cognitive decline in older subjects at risk of cardiovascular disease.
Methods:
We included 4,233 participants (mean age 75.2 years, 47.8% male) from PROSPER (PROspective Study of Pravastatin in the Elderly at Risk). LVH was assessed from baseline electrocardiograms by measuring the Sokolow-Lyon index. Higher levels of Sokolow-Lyon index indicate higher degrees of LVH. Cognitive domains involving selective attention, processing speed, and immediate and delayed memory were measured at baseline and repeated during a mean follow-up of 3.2 years.
Results:
At baseline, LVH was not associated with worse cognitive function. During follow-up, participants with higher levels of LVH had a steeper decline in cognitive function including in selective attention (p = 0.009), processing speed (p = 0.010), immediate memory (p < 0.001), and delayed memory (p = 0.002). These associations were independent of cardiovascular risk factors, co-morbidities, and medications.
Conclusion:
LVH assessed by electrocardiogram associates with steeper decline in cognitive function of older subjects independent of cardiovascular risk factors and co-morbidities. This study provides further evidence on the link between subclinical cardiac structural changes and cognitive decline in older subjects.
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