Left ventricular remodeling and diastolic dysfunction predict cognitive decline in older adults.

INTRODUCTION: Associations of cardiac structure and function with longitudinal changes in cognitive function are not known. METHODS: Among 4957 participants (age 75 ± 5 years) in the Atherosclerosis Risk in Communities study free of stroke, heart failure, and dementia who underwent protocol echocardiography and neurocognitive testing at study Visit 5 and repeat neurocognitive testing at three follow-up visits over 10 years, factor scores were derived for executive function, memory, and language and averaged into a global score. We assessed associations using multivariable linear mixed models. RESULTS: Greater left ventricular mass index, higher left atrial (LA) volume index, and lower LA reservoir strain were associated with greater decline in global cognition (p < 0.01), driven by decline in executive function. Lower ejection fraction and e' velocity associated with greater decline in memory. DISCUSSION: Subclinical left ventricular remodeling and diastolic dysfunction are associated with greater decline in cognitive function over 10 years in late life. HIGHLIGHTS: LV remodeling and diastolic dysfunction are associated with accelerated cognitive decline. This association is driven by associations with accelerated decline in EF. Lower ejection fraction and e' velocity are associated with accelerated decline in memory.