Abstract
Background: Impaired cardiac function in patients with heart failure has been linked with structural and functional alterations in the brain. Left ventricular hypertrophy (LVH) is associated with lower cardiac output which can jeopardize cerebral perfusion. In this study, we investigated whether LVH is related with accelerated cognitive decline in dementia-free older subjects at risk of cardiovascular disease. Methods: We studied 4240 men and women dementia-free subjects, mean age 75.1 years, who were enrolled in PROSPER (PROspective Study of Pravastatin in the Elderly at Risk). From baseline electrocardiograms Sokolow-Lyon Product, a measure of LVH, was calculated. Four domains of cognitive functional testing reaction time, processing speed and immediate and delayed memory were assessed at baseline and repeated during a mean follow-up of 3.2 years. The association between Sokolow-Lyon Product and annual decline in various cognitive domains were evaluated using linear regression models adjusted for socio-demographic and cardiovascular factors. Results: At baseline higher Sokolow-Lyon Product, indicating higher degrees of LVH, was associated lower cognitive scores in reaction time (p<0.001) and processing speed (p<0.001). However, the associations attenuated after adjustments for demographic and cardiovascular factors. In the longitudinal analyses, higher Sokolow-Lyon Product was associated with steeper decline in processing speed (p=0.001), immediate (p=0.001) and delayed (p=0.003) memory function. All these associations were independent of cardiovascular factors and events during follow up. Conclusion: Higher degrees of LVH are independently associated with steeper cognitive decline, in particular in processing speed and memory domains. Older subjects with LVH need to be recognized as high risk groups for cognitive impairment.
Published Version
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