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NT-proBNP and the Risk of Dementia: A Prospective Cohort Study with 14 Years of Follow-Up

Article type: Research Article

Authors: Tynkkynen, Juhoa; * | Laatikainen, Tiinab; c; d | Salomaa, Veikkob | Havulinna, Aki S.b | Blankenberg, Stefane; f | Zeller, Tanjae; f | Hernesniemi, Jussi A.a

Affiliations: [a] North Karelia Central Hospital, Joensuu, Finland | [b] National Institute for Health and Welfare, Helsinki, Finland | [c] Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland | [d] Hospital District of North Karelia, Joensuu, Finland | [e] German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Lübeck/Kiel | [f] University Heart Center Hamburg, Department of General and Interventional Cardiology, Germany

Correspondence: [*] Correspondence to: Juho Tynkkynen, Pohjois-Karjalan Keskussairaala, Tikkamäentie 16, 80210 Joensuu, Finland. Tel.: +35 850 521 9391; Fax: +35 813 171 3229; E-mail: [email protected].

Keywords: Alzheimer's disease, biological marker, dementia, N-terminal pro-BNP, population-based, prospective studies, risk

DOI: 10.3233/JAD-141809

Journal: Journal of Alzheimer's Disease, vol. 44, no. 3, pp. 1007-1013, 2015

Accepted 8 October 2014
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Published: 6 February 2015
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Supplementary Materials:

Supplementary Material.

Abstract

Background:

Memory disorders and Alzheimer's disease (AD) share the same risk factors with cardiovascular diseases.

Objective:

We tested whether elevated N-terminal pro-brain natriuretic peptide (NT-proBNP) levels would predict any incident dementia or AD.

Methods:

The association between NT-proBNP and the risk of dementia was evaluated in a total of 7,158 subjects without previous memory disorders in a prospective study with a median follow-up of 13.8 years.

Results:

A total of 220 new dementia cases occurred, of which 149 were AD. Baseline logNT-proBNP levels were associated significantly with the risk of dementia in the entire study population (HR 1.32, 95%CI 1.17–1.56, p = 0.001) per 1SD difference, adjusted for multiple cardiovascular risk factors. Integrated discrimination improvement (IDI) and continuous net-reclassification improvement (continuous NRI) were improved in the study population over 40 years of age: continuous NRI was 17.5% (95%CI 4.4–30.6%, p = 0.009) and IDI was 0.005 (95%CI 0.001–0.010, p = 0.021). Regarding AD, the HR for 1SD logNT-proBNP change was 1.23 (95%CI 1.01–1.49, p = 0.040) in the entire study population, but no IDI or continuous NRI improvement was seen.

Conclusion:

NT-proBNP is also an independent risk marker for dementia, and patient discrimination regarding dementia risk could be improved by using it.

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