1 / 22

The Cardiovascular Health Study: 1998-2004

The Cardiovascular Health Study: 1998-2004. Background and Summary of Cognitive Function Data. Introduction. Overview of CHS Cognitive Function Data in CHS Cranial MRI exams Findings to date on cognitive function. Design.

diazangela
Download Presentation

The Cardiovascular Health Study: 1998-2004

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. The Cardiovascular Health Study: 1998-2004 Background and Summary of Cognitive Function Data

  2. Introduction • Overview of CHS • Cognitive Function Data in CHS • Cranial MRI exams • Findings to date on cognitive function

  3. Design • Population-based cohort study of risk factors for stroke and coronary disease in adults aged >=65 funded by NHLBI • 5888 older adults recruited from HCFA sampling frames in 4 U.S. sites in 1989-90 and 1992-93 Fried LP. Ann Epidemiol 1991; 1: 263-276.

  4. Exclusions • Institutionalized • Unable to give informed consent • Needing a proxy to respond • Expecting to move from area in < 3 years • Under active treatment for cancer • Wheel-chair bound in the home

  5. Baseline examination • Medical history and medication use • Blood pressure and anthropometry • Diet, physical activity, psychosocial factors • Physical and cognitive function • ECG and pulmonary function • Laboratory measures • Carotid ultrasound • Echocardiography

  6. Follow-up of cohort • Methods • Semi-annual contact through 6/99 • phone call alternating with clinic visit • Phone contacts continue • Purpose • Repeat exam components • Addition of new exam components • Identify potential events

  7. Repeat exams • Blood pressure, ECGs, medical history, height, weight and medications yearly • Carotid ultrasound, years 5 & 11 • Echocardiography, year 7 • Pulmonary function, years 6 & 9

  8. New exam components • Funded by the main study • Cerebral MRI in years 5-6 and 10-11 • Retinal photograph in year 10 • Benton visual retention in yrs 6-9,11 • Funded by ancillary studies • Endothelial function in year 10 • Bone density in year 7 • Determination of dementia

  9. Events • Main endpoints--myocardial infarction, angina, heart failure, stroke, TIA and total mortality--reviewed by committees • All diagnoses and procedures from all hospitalizations captured • Cohort retention 95% through 06/99; 88% through 06/2004

  10. Cohort at Baseline

  11. Self-reported health

  12. Cognitive Function Original cohort

  13. Cognitive Function New cohort

  14. Cranial MRI • 3660 participants had an MRI between March 1992 and June 1994 • Infarct-like lesions > 3mm • White matter abnormalities, scale 0-10 • Ventricle grade, scale 0-10 Bryan et al AJNR 1994;15:1625-1633

  15. MRI completion status

  16. MRI (dementia) cohort Values in table are percents **p<.001

  17. MRI (dementia) Cohort * .001<p<.01; **p<.001

  18. White matter & 3MSE

  19. 3MSE & WMG change

  20. Cognitive Decline Change over 7 yr period. Haan et al. JAMA 1999

  21. Change in 3MSE Change over 7 yrs. (adjusted for age, sex, education) Haan et al.

  22. Final Comments • No work to date on items of 3 MSE or BVRT • MRI (dementia) cohort healthier, younger than full CHS cohort • Covariates at MRI for dementia analyses • Addition of 2nd cohort 3 years later may complicate some analyses

More Related