P029 - INFLAMMATION INTERACTS WITH POOR COGNITIVE PERFORMANCE IN ITS ASSOCIATION WITH ALL-CAUSE MORTALITY AMONG OLDER ADULTS (ID 1424)
Abstract
Aims
Dementia is a significant public health problem which leads to poor health outcomes. Inflammatory biomarkers have been found to be important in signaling cardiovascular disease. In this study, we determined whether the longitudinal evidence supports the need to use biomarkers like C-reactive protein (CRP) as poor prognostic indicators for cognitive decline, especially in individuals with congestive heart failure (CHF).
Methods
We used population-based cohort study of 1999-2002 National Health and Nutrition Examination Surveys with mortality data obtained through 2015. Adults aged 60 years or older with CHF were assessed for cognitive skills using Digit Symbol Substitution Test (DSST). Outcomes of all-cause mortality were evaluated using Cox regression at various levels of CRP (vs. ≤2ug/dL).
Results
Percent of deaths from low cognitive function among the population (N=160) were higher among Hispanic Americans (12.0%) than Caucasians (9.4%). The mean follow-up was 8.2 years. For all-cause mortality, the overall unadjusted hazard ratio (HR) of low cognitive function was 1.91 (95% confidence interval [CI], 1.05-3.45, p < 0.03). Adjusted HR was elevated, 15.31 (CI 4.67-50.15, p < 0.001), among elevated CRP and low cognitive function but closer to 1.0 (1.36 CI 0.74-2.51, p < 0.31) among those with normal CRP and low cognitive function, after controlling for medical (obesity) and demographic risk factors (age and sex).
Conclusions
Our research shows that low cognitive function leads to higher mortality, especially among individuals with elevated biomarkers once they have developed CHF. Improved identification of dementia, increased surveillance efforts, and addressing issues with health equity are needed to improve survival.
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