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Association of parathyroid hormone with 20-year cognitive decline: The ARIC study.

TitleAssociation of parathyroid hormone with 20-year cognitive decline: The ARIC study.
Publication TypeJournal Article
Year of Publication2017
AuthorsKim SM, Zhao D, Schneider ALC, Korada SKrishna, Lutsey PL, Guallar E, Alonso A, B Windham G, Gottesman RF
Secondary AuthorsMichos ED
Date Published2017 Aug 29
KeywordsBiomarkers, Cognitive Dysfunction, Cross-Sectional Studies, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Middle Aged, Neuropsychological Tests, Parathyroid Hormone, Prospective Studies, Time Factors

OBJECTIVE: We hypothesized that elevated parathyroid hormone (PTH) levels will be independently associated with 20-year cognitive decline in a large population-based cohort.

METHODS: We studied 12,964 middle-aged white and black ARIC participants without a history of prior stroke who, in 1990-1992 (baseline), had serum PTH levels measured and cognitive function testing, with repeat cognitive testing performed at up to 2 follow-up visits. Cognitive testing included the Delayed Word Recall, the Digit Symbol Substitution, and the Word Fluency tests, which were summed as a global score. Using mixed-effects models, we compared the relative decline in individual and global cognitive scores between each of the top 3 quartiles of PTH levels to the reference bottom quartile. We adjusted for demographic variables, education, vascular risk factors, and levels of calcium, phosphate, and vitamin D. We imputed missing covariate and follow-up cognitive data to account for attrition.

RESULTS: The mean (SD) age of our cohort was 57 (6) years, 57% were women, and 24% were black. There was no cross-sectional association of elevated PTH with cognitive global score at baseline ( > 0.05). Over a median of 20.7 years, participants in each PTH quartile showed a decline in cognitive function. However, there was no significant difference in cognitive decline between each of the top 3 quartiles and the lowest reference quartile ( > 0.05). In a subset, there was also no association of higher mid-life PTH levels with late-life prevalent adjudicated dementia ( > 0.05).

CONCLUSIONS: Our work does not support an independent influence of PTH on cognitive decline in this population-based cohort study.

Alternate JournalNeurology
PubMed ID28768841
PubMed Central IDPMC5577963
Grant ListU01 HL096812 / HL / NHLBI NIH HHS / United States
U01 HL096917 / HL / NHLBI NIH HHS / United States
U01 HL096902 / HL / NHLBI NIH HHS / United States
U01 HL096814 / HL / NHLBI NIH HHS / United States
U01 HL096899 / HL / NHLBI NIH HHS / United States