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Cognition and incident dementia hospitalization: results from the atherosclerosis risk in communities study.

TitleCognition and incident dementia hospitalization: results from the atherosclerosis risk in communities study.
Publication TypeJournal Article
Year of Publication2013
AuthorsSchneider ALC, Gottesman RF, Mosley T, Alonso A, Knopman DS, Coresh JJ, Sharrett ARichey
Secondary AuthorsSelvin E
JournalNeuroepidemiology
Volume40
Issue2
Pagination117-24
Date Published2013
ISSN1423-0208
KeywordsCausality, Cognition Disorders, Cohort Studies, Comorbidity, Dementia, Female, Hospitalization, Humans, Incidence, Intracranial Arteriosclerosis, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Risk Assessment, Survival Rate, United States
Abstract

BACKGROUND/AIMS: Cognitive decline is a defining feature of dementia. We sought to determine if a single baseline cognitive test score or change in test score over time is more strongly associated with risk of dementia hospitalization. We also sought to compare short- and long-term dementia risk.

METHODS: Prospective cohort study of 9,399 individuals from the Atherosclerosis Risk in Communities Study (median 10 years of follow-up). Cognition was assessed at two time points (6 years apart) using three tests: Delayed Word Recall Test (DWRT), Digit Symbol Substitution Test (DSST), and Word Fluency Test. Dementia hospitalizations were determined using ICD-9 codes.

RESULTS: Baseline cognitive test scores were associated with both short-term and long-term risk of dementia. The association of 6-year change in cognitive test score with dementia risk was stronger than that of individual test scores at a single visit [change from highest to lowest tertile, DWRT: hazard ratio = 6.45 (95% confidence interval = 1.80-23.08); DSST: hazard ratio = 10.94 (95% confidence interval = 3.07-38.97)].

CONCLUSIONS: In this community-based population, 6-year changes in cognitive scores were more strongly associated with risk of incident dementia hospitalization than baseline scores, although single DWRT and DSST scores were predictive. Our findings support the contention that cognitive changes may precede clinical dementia by a decade or more.

DOI10.1159/000342308
Alternate JournalNeuroepidemiology
PubMed ID23095770
PubMed Central IDPMC3642775
Grant ListHHSN268201100012C / HL / NHLBI NIH HHS / United States
HHSN268201100009I / HL / NHLBI NIH HHS / United States
HHSN262801100010C / / PHS HHS / United States
HHSN262801100009C / / PHS HHS / United States
HHSN262801100011C / / PHS HHS / United States
HHSN262801100012C / / PHS HHS / United States
HHSN268201100010C / HL / NHLBI NIH HHS / United States
HHSN268201100008C / HL / NHLBI NIH HHS / United States
HHSN268201100005G / HL / NHLBI NIH HHS / United States
HHSN268201100008I / HL / NHLBI NIH HHS / United States
HHSN268201100005C / / PHS HHS / United States
HHSN268201100007C / HL / NHLBI NIH HHS / United States
HHSN268201100011I / HL / NHLBI NIH HHS / United States
HHSN268201100011C / HL / NHLBI NIH HHS / United States
HHSN262801100008C / / PHS HHS / United States
HHSN268201100006C / HL / NHLBI NIH HHS / United States
HHSN268201100005I / HL / NHLBI NIH HHS / United States
HHSN262801100007C / / PHS HHS / United States
HHSN268201100009C / HL / NHLBI NIH HHS / United States
HHSN268201100005C / HL / NHLBI NIH HHS / United States
HHSN268201100007I / HL / NHLBI NIH HHS / United States
T32 DK062707 / DK / NIDDK NIH HHS / United States
HHSN262801100006C / / PHS HHS / United States