atrial-natriuretic-factor and Cognition-Disorders

It is known that blood levels of natriuretic peptides associate with cognitive disorder among the middle-aged. We aimed to test whether this association is valid in an older population aged 75 years or older.. A total of 601 older subjects aged 75 or older participated in the study. A subgroup of 137 with a diagnosed cognitive disorder were tested for natriuretic peptides (ANP, NT-proANP, and BNP), and compared with age-matched controls (n = 464). The control group was followed-up for 5 years, and the association of the baseline BNP with the occurrence of cognitive impairment was studied.. In the youngest age tertile (75-78 y), BNP was significantly associated with a diagnosed cognitive disorder when other factors with a known effect on natriuretic peptides were taken into account. In the oldest tertile (83-96 y), higher BNP values suggested the absence of cognitive dysfunction. ANP and NT-proANP did not associate with the presence of cognitive impairment. Among the control group, BNP predicted a cognitive disorder at follow-up, but only in the youngest tertile.. The previously found link between a high BNP concentration and cognitive disorder in older people is only valid among those aged less than 79 years.

Topics: Age Factors; Aged; Aged, 80 and over; Alzheimer Disease; Analysis of Variance; Atrial Natriuretic Factor; Case-Control Studies; Cognition Disorders; Dementia, Vascular; Female; Humans; Lewy Body Disease; Male; Multivariate Analysis; Natriuretic Peptide, Brain; Predictive Value of Tests; Prognosis

Development of biomarkers for early detection of Alzheimer's disease (AD) is a major clinical research goal. On the basis of the hypothesis that cardiovascular risk factors contribute to the pathogenesis of AD, we investigated whether the cardiovascular risk markers midregional proadrenomedullin (MR-proADM) and midregional proatrial natriuretic peptide (MR-proANP) predict a major clinical milestone, ie, conversion from predementia mild cognitive impairment (MCI) to manifest AD.. A group of 134 MCI patients, among 137 originally prospectively recruited at the memory disorder clinic at Malmö University Hospital, Malmö, Sweden, between July 1998 and June 2001, was clinically followed for 4-6 years. We determined whether plasma concentrations of MR-proADM and MR-proANP at baseline predicted time to conversion from MCI to clinically diagnosed AD (DSM-III-R). MCI was diagnosed according to Petersen criteria.. During follow-up, 41.8% of MCI patients remained cognitively stable, 42.5% converted to possible and probable AD, and 15.7% converted to other forms of dementia (MCI-other). MCI converters and MCI-other patients showed increased concentrations of MR-proANP and MR-proADM compared to the stable MCI patients (P = .0001). At a cutoff of 87 pmol/L, MR-proANP yielded a sensitivity of 73.7% and a specificity of 64.3% for predicting conversion to AD. The survival analysis showed that higher values of MR-proANP and MR-proADM were associated with progression to AD. In a multivariate Cox regression model including known risk factors, MR-proANP and MR-proADM remained independent risk factors for conversion to AD for patients below the age of 72 years.. Our study shows that plasma concentrations of MR-proANP and MR-proADM have predictive value in the progression from predementia MCI to clinical AD. Sensitivity was particularly high, which may recommend this test for first-stage screening in patients at risk for AD.

Topics: Adrenomedullin; Aged; Alzheimer Disease; Analysis of Variance; Atrial Natriuretic Factor; Biomarkers; Chi-Square Distribution; Cognition Disorders; Disease Progression; Female; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Predictive Value of Tests; Proportional Hazards Models; Protein Precursors; Retrospective Studies; Statistics, Nonparametric

Hypertension is a major risk factor of Alzheimer's disease (AD); however, controlled studies on the effect of antihypertensive treatment on the risk of dementia are inconclusive. Therefore, a biological marker that predicts individual response to antihypertensive treatment would be of high clinical relevance. Midregional proatrial natriuretic peptide (MR-proANP), an inactive surrogate molecule of the mature atrial natriuretic peptide, is related to circulatory function and hypertension.. A sample population of 134 subjects with mild cognitive impairment (MCI) was followed for up to 6 years. Multivariable Cox regression analysis was conducted to predict conversion to AD based on all relevant variables.. Baseline MR-proANP was significantly increased in the AD converter group (p < .0001). The conversion rate of patients treated with antihypertensive drugs was significantly reduced only in patients with elevated MR-proANP at baseline (p = .046). Using an optimized MR-proANP cutoff of 74 pmol/L, representing a value in the upper normal range, treatment with antihypertensive drugs reduced the conversion rate to AD by 36% (p = .035) for patients with levels >74 pmol/L. Further subgrouping by age (>/≤ 72 years at baseline) increased the positive correlation of antihypertensive treatment and MCI outcome for patients below the age of 72 years (conversion rate reduced by 74%, p = .016).. These data seem to support the notion of a potential impact of circulatory function for the prognosis of AD at a prodromal stage. The MR-proANP levels may be useful to predict the effect of antihypertensive treatment on conversion rates to AD in subjects with MCI.

Topics: Aged; Alzheimer Disease; Antihypertensive Agents; Atrial Natriuretic Factor; Blood Pressure; Cognition Disorders; Disease Progression; Female; Humans; Hypertension; Kaplan-Meier Estimate; Longitudinal Studies; Male; Middle Aged; Regression Analysis; Retrospective Studies

Topics: Alzheimer Disease; Antihypertensive Agents; Atrial Natriuretic Factor; Cognition Disorders; Female; Humans; Male

High plasma brain natriuretic peptide (BNP) concentrations have been observed in patients with ischemic stroke, as well as cardiovascular disease. Furthermore, a recent report suggests that BNP may predict cognitive dysfunction in older patients with cardiovascular disease. The purpose of this study is to estimate the clinical impression of brain natriuretic peptide (BNP) in demented patients without cardiovascular disease.. The Revised Hasegawa Dementia Scale (HDS-R), age, echocardiographic parameters, and plasma atrial natriuretic peptide (ANP) and BNP levels were assessed in 42 outpatients at the Dementia Care Unit in Watanabe Hospital.. Some BNP levels were more than normal reference values, while any ANP levels were no more than normal reference values. BNP levels were significantly correlated (i.e. negative correlation) with HDS-R (r = -0.33, P = 0.03), whereas those were not significantly correlated with age and echocardiographic parameters.. This study shows that BNP levels were significantly correlated with cognitive function in demented patients without cardiovascular disease, and suggests that BNP may support the assessment of cognitive dysfunction in demented patients.

Topics: Aged; Atrial Natriuretic Factor; Cardiovascular Diseases; Cognition Disorders; Dementia; Female; Humans; Male; Natriuretic Peptide, Brain

An old women was in an 8-year-period 9 times admitted to the hospital because of severe mental disturbances. The average serum sodium concentration was 126.25 +/- 2.43 mmol/l at the admissions; it increased to 139.44 +/- 1.40 mmol/l after intravenous infusion of hypertonic solutions accompanied with the disappearance of the mental disturbances. The patient was usually chronically hyponatremic due to the increased water intake and the insufficient water excretion. The latter was induced by the augmented vasopressin levels. The remarkable feature of the syndrome of inappropriate antidiuretic hormone secretion was its association with lowered blood level of atrial natriuretic factor accompanied by sodium, and volume depletion. Discontinuation of the exaggerated water intake resulted in the elimination of the permanent hyponatremia; no episode of water intoxication occurred during the last 3 and 1/2 years.

Topics: Aged; Atrial Natriuretic Factor; Cognition Disorders; Drinking Behavior; Female; Humans; Hyponatremia; Inappropriate ADH Syndrome; Vasopressins; Water Intoxication