Activation of hemostasis and decline in cognitive function in older people.
Authors
Stott, David JRobertson, Michele
Rumley, Ann
Welsh, Paul
Sattar, Naveed
Packard, Christopher J
Shepherd, James
Trompet, Stella
Westendorp, Rudi G J
de Craen, Anton J M
Jukema, J Wouter
Buckley, Brendan
Ford, Ian
Lowe, Gordon D O
Affiliation
Academic Section of Geriatric Medicine, 3 Floor Queen Elizabeth Building, Royal Infirmary, Glasgow G31 2ER. d.j.stott@clinmed.gla.ac.ukIssue Date
2010-03MeSH
Activities of Daily LivingAge Factors
Aged
Aged, 80 and over
Biological Markers
Cognition
Cognition Disorders
Dementia, Vascular
Female
Fibrin Fibrinogen Degradation Products
Fibrinogen
Follow-Up Studies
Hemostasis
Humans
Male
Prothrombin
Risk Factors
Metadata
Show full item recordCitation
Activation of hemostasis and decline in cognitive function in older people. 2010, 30 (3):605-11 Arterioscler. Thromb. Vasc. Biol.Journal
Arteriosclerosis, thrombosis, and vascular biologyDOI
10.1161/ATVBAHA.109.199448PubMed ID
20032290Additional Links
http://atvb.ahajournals.org/content/30/3/605.full.pdf+htmlAbstract
To determine whether activation of hemostatic function (thrombosis and fibrinolysis) is associated with cognitive decline in older people.We studied 5804 people (age, 70-82 years) in the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER). Mean follow-up was 3.2 years, including annual measurement of speed of information processing (letter, digit coding, and Stroop), verbal memory (picture-word naming), and basic and instrumental activities of daily living. Raised levels of markers of thrombin generation (d-dimer and prothrombin fragment 1+2) were associated independently with increased rate of cognitive decline (eg, Stroop increased by 4.44 s [SEM, 0.68] in bottom tertile of d-dimer compared to 5.46 [SEM, 0.71] in highest tertile; P<0.05) and deterioration in activities of daily living. This increased rate of decline was attenuated but not removed when subjects with incident nonfatal stroke were omitted from the analysis. It also persisted when adjustments were made for inflammation (C-reactive protein and IL-6).
Older patients with increased markers of thrombin generation (d-dimer and prothrombin fragment 1+2) are at increased risk for cognitive decline and deterioration in ability to perform activities of daily living. This is likely attributable to increased risk of cerebral ischemic damage (including covert disease) associated with prothrombotic states.
Item Type
ArticleLanguage
enISSN
1524-4636ae974a485f413a2113503eed53cd6c53
10.1161/ATVBAHA.109.199448
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