Abstract
We aimed to investigate the cross-sectional and longitudinal associations of electrocardiogram (ECG)-based QT, QTc, JT, JTc, and QRS intervals with cognitive function and brain magnetic resonance imaging (MRI) measurements in a cohort of older individuals at increased risk for cardiovascular disease, but free of known arrhythmias. We studied 4627 participants (54% female, mean age 75 years) enrolled in the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER). Ten-second ECGs were conducted at baseline. Cognitive function was tested at baseline and repeated during a mean follow-up time of 3.2 years. Structural MRIs were conducted in a subgroup of 535 participants. Analyses were performed with multivariable (repeated) linear regression models and adjusted for cardiovascular risk-factors, co-morbidities, and cardiovascular drug use. At baseline, longer QT, JT, JTc—but not QTc and QRS intervals—were associated with a worse cognitive performance. Most notably, on the Stroop Test, participants performed 3.02 (95% CI 0.31; 5.73) seconds worse per standard deviation higher QT interval, independent of cardiovascular risk factors and medication use. There was no association between longer ventricular de- or repolarization and structural brain measurements. Therefore, specifically ventricular repolarization was associated with worse cognitive performance in older individuals at baseline but not during follow-up.
Highlights
The incidence of dementia has increased in the last decades as a consequence of a growing number of older individuals [1]
A third were current smokers (n = 1255, 27.1%) and almost half had a history of cardiovascular disease (n = 1996, 43.1%)
This study explored the associations between the extent of ventricular depolarization and repolarization, and various domains of cognitive functioning and brain magnetic resonance imaging (MRI) measures in a cohort of older individuals at increased risk for cardiovascular disease
Summary
The incidence of dementia has increased in the last decades as a consequence of a growing number of older individuals [1]. Cardiac function markers, such as heart-rate variability and left ventricular hypertrophy, have been associated with worsened cognitive function and abnormalities within the brain, such as white matter hypertensities (WMH), as seen in dementia [6,10,11,12,13]. Studies using magnetic resonance imaging (MRI) have demonstrated that a high microbleed count, as a marker of diffuse vascular brain damage, is associated with an increased risk for cognitive decline and dementia [14]. Other well-known cardiovascular risk factors that contribute to brain diseases, such as dementia, include hypertension, hypercholesteremia, diabetes, obesity, and smoking [7,15,16]
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