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B-type natriuretic peptide as a predictor of declining cognitive function and dementia--a cohort study of an elderly general population with a 5-year follow-up.

https://arctichealth.org/en/permalink/ahliterature144288
Source
Ann Med. 2010 Apr;42(3):207-15
Publication Type
Article
Date
Apr-2010
Author
Tuomas Kerola
Tuomo Nieminen
Sirpa Hartikainen
Raimo Sulkava
Olli Vuolteenaho
Raimo Kettunen
Author Affiliation
Department of Internal Medicine, Päijät-Häme Central Hospital, Lahti, Finland. tuomas.kerola@phsotey.fi
Source
Ann Med. 2010 Apr;42(3):207-15
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cognition
Cognition Disorders - blood - epidemiology
Cohort Studies
Dementia - blood - epidemiology
Educational Status
Female
Finland - epidemiology
Follow-Up Studies
Humans
Hypertension - complications
Male
Multivariate Analysis
Natriuretic Peptide, Brain - blood
Predictive value of tests
Risk factors
Abstract
Several traditional cardiovascular risk factors assessed in the middle-aged are associated with the risk of dementia, but they are known to lose much of their prognostic value when measured in the elderly. The aim of the study was to compare B-type natriuretic peptide (BNP) with previously known risk markers for dementia in their association with cognitive decline and dementia during a follow-up.
A total of 464 subjects free of dementia aged 75 years or more were examined and followed up for 5 years in a prospective population-based stratified cohort study. The association of clinical variables to base-line Mini Mental State Examination score (MMSE), the decline of MMSE, and onset of dementia during the follow-up were examined.
The only variable to significantly associate with the decline of MMSE was BNP (beta 0.140; P = 0.019). A total of 59 new cases of dementia were diagnosed after the follow-up. Significant predictors of the occurrence of dementia over the study period were BNP (adjusted odds ratio (OR) 1.53; 95% confidence interval (CI) 1.09-2.16; P = 0.013), length of education (OR 0.50; 95% CI 0.33-0.77; P = 0.001), and diagnosis of hypertension (OR 0.53; 95% CI 0.27-0.95; P = 0.036). BNP remained as a significant predictor of dementia and the decline of MMSE even after adjustment to the base-line MMSE.
BNP is an independent harbinger of the cognitive decline and incidence of new onset of dementia in an elderly general population. This is a ground for testing the impact of antihypertensive treatment in the prevention of cognitive impairment in those with elevated BNP.
PubMed ID
20384435 View in PubMed
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Depressive symptoms and cardiovascular burden-related mortality among the aged.

https://arctichealth.org/en/permalink/ahliterature258945
Source
Eur J Clin Invest. 2014 May;44(5):486-92
Publication Type
Article
Date
May-2014
Author
Matti Hiltunen
Tuomo Nieminen
Raimo Kettunen
Sirpa Hartikainen
Raimo Sulkava
Olli Vuolteenaho
Tuomas Kerola
Source
Eur J Clin Invest. 2014 May;44(5):486-92
Date
May-2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Biological Markers - metabolism
Cardiovascular Diseases - blood - mortality - psychology
Cost of Illness
Depression - blood - mortality
Epidemiologic Methods
Female
Finland - epidemiology
Humans
Male
Natriuretic Peptide, Brain - metabolism
Abstract
Depressive symptoms have been linked to increased cardiovascular mortality among the elderly. This study was aimed to test the independent and additive predictive value of depressive symptoms and B-type natriuretic peptide (BNP), a marker of direct cardiovascular stress and a strong predictor of mortality, together with traditional cardiovascular risk markers on total and cardiovascular mortalities in a general elderly population.
A total of 508 subjects aged 75 or older participated in the study. The prognostic capacity of depressive symptoms and BNP in regard to total and cardiovascular mortalities was assessed with Cox regression analyses. Depressive symptoms were handled as a dichotomous variable based on the Zung self-rated depression scale score with a cut-off point of 40.
The median follow-up time was 84?months with an interquartile range of 36-99?months. Depressive symptoms reflected susceptibility to all-cause (HR 1?60; 95% CI 1?26-2?04) and cardiovascular mortalities (HR 1?81; 95% CI 1?30-2?52) only in univariable analyses. When cardiovascular illnesses and risk markers were taken into account, depressive symptoms lost their significance as an independent predictor of mortality. BNP as a continuous variable was a significant predictor of both all-cause (HR 1?44; 95% CI 1?22-1?69) and cardiovascular mortalities (HR 1?79; 95% CI 1?44-2?22) in fully adjusted models including depressive symptoms as a covariate.
The prognostic capacity of depressive symptoms is closely linked to cardiovascular morbidity and has no independent power in an elderly general population. BNP remains a strong harbinger of death regardless of depressive symptoms status.
PubMed ID
24621379 View in PubMed
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Mini-Mental State Examination score and B-type natriuretic peptide as predictors of cardiovascular and total mortality in an elderly general population.

https://arctichealth.org/en/permalink/ahliterature139947
Source
Ann Med. 2011 Dec;43(8):650-9
Publication Type
Article
Date
Dec-2011
Author
Tuomas Kerola
Matti Hiltunen
Raimo Kettunen
Sirpa Hartikainen
Raimo Sulkava
Olli Vuolteenaho
Tuomo Nieminen
Author Affiliation
Department of Internal Medicine, Päijät-Häme Central Hospital, Lahti, Finland. tuomas.kerola@phsotey.fi
Source
Ann Med. 2011 Dec;43(8):650-9
Date
Dec-2011
Language
English
Publication Type
Article
Keywords
Aged
Cardiovascular Diseases - mortality
Cognition Disorders - blood - diagnosis
Dementia - blood - diagnosis
Female
Finland - epidemiology
Geriatric Assessment
Heart Failure - diagnosis - mortality
Humans
Male
Mild Cognitive Impairment - blood - diagnosis
Mortality
Multivariate Analysis
Natriuretic Peptide, Brain - blood
Neuropsychological Tests
Predictive value of tests
Proportional Hazards Models
Prospective Studies
Abstract
INTRODUCTION. The aim of the present study was to examine the power of B-type natriuretic peptide (BNP) and mild cognitive impairment as independent predictors of total and cardiovascular mortality in combination with established cardiovascular risk markers in an elderly general population without severe cognitive impairment. METHODS. A total of 499 individuals, aged more than 75 years, were examined and followed up for a median of 7.9 years in a prospective population-based stratified cohort study carried out in eastern Finland. The Cox proportional hazards regression model was used to determine the impact of multiple factors on total and cardiovascular mortality. RESULTS. In a multivariable model including established cardiovascular risk factors and conditions, both continuous BNP (adjusted hazard ratio (HR) 1.44 for a 1-SD change; 95% confidence interval (CI) 1.22-1.77; P
PubMed ID
20961273 View in PubMed
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