Incident Heart Failure and Cognitive Decline: The Atherosclerosis Risk in Communities Study

Jan Bressler, David S. Knopman, A. Richey Sharrett, Rebecca F. Gottesman, Alan Penman, Patricia P. Chang, Wayne D. Rosamond, Eric Boerwinkle, Thomas H. Mosley

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Background Cognitive impairment is found in a significant proportion of patients with heart failure (HF). Although cognitive impairment may be a consequence of HF, early signs of cognitive impairment may also indicate subclinical vascular disease, and thus a risk factor for future cardiovascular events. Methods and Results The Atherosclerosis Risk in Communities Study is a prospective cohort study of the development of atherosclerosis. Cox proportional hazards regression was used to examine the association between mean 6-year change in cognitive function and incident HF in 7962 white and 1933 African-American men and women aged 46 to 70 years and free of clinical stroke. Scores were obtained for the Delayed Word Recall Test, the Digit Symbol Substitution Test (DSST), and the Word Fluency Test. There was a significantly increased risk of developing HF during the mean 12.6-year follow-up period after adjustment for age, gender, race, and education for those in the quartile with the greatest decline in DSST scores (hazard ratio [HR] = 1.17, P = .009), and in the quartile with the lowest baseline DSST scores (HR = 1.43, P < .001). Conclusions The results suggest that relatively low performance on a test of information processing speed may serve as an indicator of HF risk in middle age.

Original languageEnglish (US)
Pages (from-to)47-55
Number of pages9
JournalJournal of Cardiac Failure
Issue number1
StatePublished - Jan 1 2017


  • Epidemiology
  • cognition

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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