Korean J Fam Pract. 2018; 8(5): 709-715  https://doi.org/10.21215/kjfp.2018.8.5.709
Assessment of Association between Cognitive Impairment and Cardio-Cerebrovascular Disease
Jeong-yeon Yun1, Soo-jin Wang1, Mi-so Jang1, Soo-Min Jung1, Sang-Hyuck Kim2, Jae-Moon Yun1, Ki-Young Son1, Be-long Cho1, Ji-Eun Lee3,*, Dong-wook Shin4,*
1Department of Family Medicine, Seoul National University Hospital, Seoul; 2Department of Family Medicine, Osan Hankook Hostpital, Osan; 3Department of Family Medicine, Cha Bundang Medical Center, Seongnam; 4Department of Family Medicine, Samsung Medical Center, Seoul, Korea
Ji-Eun Lee
Tel: +82-2-2072-3335, Fax: +82-2-2071-4981
E-mail: jieun10@gmail.com
ORCID: http://orcid.org/0000-0003-3171-1713 Dong-wook Shin
Tel: +82-2-2072-3335, Fax: +82-2-2071-4981
E-mail: dwshin.md@gmail.com
ORCID: http://orcid.org/0000-0001-8128-8920
Received: July 20, 2017; Revised: September 18, 2017; Accepted: October 7, 2017; Published online: October 20, 2018.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Cardio-cerebrovascular disease is an important medical problem and is a leading cause of death worldwide. Since it shares a number of risk factors with cognitive impairment, it is necessary to confirm the relationship between the two diseases and to investigate the possibility of cognitive function as a predictive marker for cardio-cerebrovascular disease.
Methods: The study population included participants of the National Health Screening for People in a Transitional Period - 66 years old. Participants who did not answer all the 5 questions related to cognitive function and those who had experienced myocardial infarction or stroke before the day of screening were excluded. In all, 63,350 participants were included in the analysis. The risks of myocardial infarction and stroke occurrence according to the baseline cognitive function were assessed by Cox proportional hazards analysis. In addition, these factors were analyzed in a multivariable model including typical cardiovascular risk factors.
Results: The cognitive impairment group had higher risks of myocardial infarction (hazard ratio [HR] 1.99, 95% confidence interval [CI] 1.06–3.75) and stroke occurrence (HR 1.46, 95% CI 1.05–2.03) than the non-impairment group. The risks were also significantly higher according to the multivariable model including typical cardiovascular risk factors, namely sex, hypertension, diabetes mellitus, dyslipidemia, obesity, and smoking (adjusted HR 2.12, 95% CI 1.13–4.01 for myocardial infarction, adjusted HR 1.45, 95% CI 1.04–2.01 for stroke).
Conclusion: The cognitive impairment group had a significantly higher risk of subsequent myocardial infarction and stroke occurrence than the non-impairment group. Thus, cognitive impairment may serve as a predictive marker for cardio-cerebrovascular disease.
Keywords: Cognitive Function; Prescreening Korean Dementia Screening Questionnaires; Cardiovascular Event; Stroke
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