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Lower Performance in Orientation to Time and Place Associates with Greater Risk of Cardiovascular Events and Mortality in the Oldest Old: Leiden 85-Plus Study

Background: Impairment in orientation to time and place is commonly observed in community-dwelling older individuals. Nevertheless, the clinical significance of this has been not fully explored. In this study, we investigated the link between performance in orientation domains and future risk of car...

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Autores principales: Rostamian, Somayeh, van Buchem, Mark A., Jukema, J. Wouter, Gussekloo, Jacobijn, Poortvliet, Rosalinde K. E., de Cren, Anton J. M., Sabayan, Behnam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5623724/
https://www.ncbi.nlm.nih.gov/pubmed/29021754
http://dx.doi.org/10.3389/fnagi.2017.00307
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author Rostamian, Somayeh
van Buchem, Mark A.
Jukema, J. Wouter
Gussekloo, Jacobijn
Poortvliet, Rosalinde K. E.
de Cren, Anton J. M.
Sabayan, Behnam
author_facet Rostamian, Somayeh
van Buchem, Mark A.
Jukema, J. Wouter
Gussekloo, Jacobijn
Poortvliet, Rosalinde K. E.
de Cren, Anton J. M.
Sabayan, Behnam
author_sort Rostamian, Somayeh
collection PubMed
description Background: Impairment in orientation to time and place is commonly observed in community-dwelling older individuals. Nevertheless, the clinical significance of this has been not fully explored. In this study, we investigated the link between performance in orientation domains and future risk of cardiovascular events and mortality in a non-hospital setting of the oldest old adults. Methods: We included 528 subjects free of myocardial infarction (Group A), 477 individuals free of stroke/transient ischemic attack (Group B), and 432 subjects free of both myocardial infarction and stroke/transient ischemic attack (Group C) at baseline from the population-based Leiden 85-plus cohort study. Participants were asked to answer five questions related to orientation to time and five questions related to orientation to place. 5-year risks of first-time fatal and non-fatal myocardial infarction, fatal and non-fatal stroke, as well as cardiovascular and non-cardiovascular mortality, were estimated using the multivariate Cox regression analysis. Results: In the multivariable analyses, adjusted for sociodemographic characteristics and cardiovascular risk factors, each point lower performance in “orientation to time” was significantly associated with higher risk of first-time myocardial infarction (hazard ratio [HR] 1.35, 95% confidence interval [CI] 1.09–1.67, P = 0.007), first-time stroke (HR 1.35, 95% CI 1.12–1.64, P = 0.002), cardiovascular mortality (HR 1.28, 95% CI 1.06–1.54, P = 0.009) and non-cardiovascular mortality (HR 1.37, 95% CI 1.20–1.56, P < 0.001). Similarly, each point lower performance in “orientation to place” was significantly associated with higher risk of first-time myocardial infarction (HR 1.67, 95% CI 1.25–2.22, P = 0.001), first-time stroke (HR 1.39, 95% CI 1.05–1.82, P = 0.016), cardiovascular mortality (HR 1.35, 95% CI 1.00–1.82, P = 0.054) and non-cardiovascular mortality (HR 1.45, 95% CI 1.20–1.77, P < 0.001). Conclusions: Lower performance in orientation to time and place in advanced age is independently related to higher risk of myocardial infarction, stroke and mortality. Impaired orientation might be an early sign of covert vascular injuries, putting subjects at greater risk of cardiovascular events and mortality.
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spelling pubmed-56237242017-10-11 Lower Performance in Orientation to Time and Place Associates with Greater Risk of Cardiovascular Events and Mortality in the Oldest Old: Leiden 85-Plus Study Rostamian, Somayeh van Buchem, Mark A. Jukema, J. Wouter Gussekloo, Jacobijn Poortvliet, Rosalinde K. E. de Cren, Anton J. M. Sabayan, Behnam Front Aging Neurosci Neuroscience Background: Impairment in orientation to time and place is commonly observed in community-dwelling older individuals. Nevertheless, the clinical significance of this has been not fully explored. In this study, we investigated the link between performance in orientation domains and future risk of cardiovascular events and mortality in a non-hospital setting of the oldest old adults. Methods: We included 528 subjects free of myocardial infarction (Group A), 477 individuals free of stroke/transient ischemic attack (Group B), and 432 subjects free of both myocardial infarction and stroke/transient ischemic attack (Group C) at baseline from the population-based Leiden 85-plus cohort study. Participants were asked to answer five questions related to orientation to time and five questions related to orientation to place. 5-year risks of first-time fatal and non-fatal myocardial infarction, fatal and non-fatal stroke, as well as cardiovascular and non-cardiovascular mortality, were estimated using the multivariate Cox regression analysis. Results: In the multivariable analyses, adjusted for sociodemographic characteristics and cardiovascular risk factors, each point lower performance in “orientation to time” was significantly associated with higher risk of first-time myocardial infarction (hazard ratio [HR] 1.35, 95% confidence interval [CI] 1.09–1.67, P = 0.007), first-time stroke (HR 1.35, 95% CI 1.12–1.64, P = 0.002), cardiovascular mortality (HR 1.28, 95% CI 1.06–1.54, P = 0.009) and non-cardiovascular mortality (HR 1.37, 95% CI 1.20–1.56, P < 0.001). Similarly, each point lower performance in “orientation to place” was significantly associated with higher risk of first-time myocardial infarction (HR 1.67, 95% CI 1.25–2.22, P = 0.001), first-time stroke (HR 1.39, 95% CI 1.05–1.82, P = 0.016), cardiovascular mortality (HR 1.35, 95% CI 1.00–1.82, P = 0.054) and non-cardiovascular mortality (HR 1.45, 95% CI 1.20–1.77, P < 0.001). Conclusions: Lower performance in orientation to time and place in advanced age is independently related to higher risk of myocardial infarction, stroke and mortality. Impaired orientation might be an early sign of covert vascular injuries, putting subjects at greater risk of cardiovascular events and mortality. Frontiers Media S.A. 2017-09-27 /pmc/articles/PMC5623724/ /pubmed/29021754 http://dx.doi.org/10.3389/fnagi.2017.00307 Text en Copyright © 2017 Rostamian, van Buchem, Jukema, Gussekloo, Poortvliet, de Cren and Sabayan. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neuroscience
Rostamian, Somayeh
van Buchem, Mark A.
Jukema, J. Wouter
Gussekloo, Jacobijn
Poortvliet, Rosalinde K. E.
de Cren, Anton J. M.
Sabayan, Behnam
Lower Performance in Orientation to Time and Place Associates with Greater Risk of Cardiovascular Events and Mortality in the Oldest Old: Leiden 85-Plus Study
title Lower Performance in Orientation to Time and Place Associates with Greater Risk of Cardiovascular Events and Mortality in the Oldest Old: Leiden 85-Plus Study
title_full Lower Performance in Orientation to Time and Place Associates with Greater Risk of Cardiovascular Events and Mortality in the Oldest Old: Leiden 85-Plus Study
title_fullStr Lower Performance in Orientation to Time and Place Associates with Greater Risk of Cardiovascular Events and Mortality in the Oldest Old: Leiden 85-Plus Study
title_full_unstemmed Lower Performance in Orientation to Time and Place Associates with Greater Risk of Cardiovascular Events and Mortality in the Oldest Old: Leiden 85-Plus Study
title_short Lower Performance in Orientation to Time and Place Associates with Greater Risk of Cardiovascular Events and Mortality in the Oldest Old: Leiden 85-Plus Study
title_sort lower performance in orientation to time and place associates with greater risk of cardiovascular events and mortality in the oldest old: leiden 85-plus study
topic Neuroscience
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5623724/
https://www.ncbi.nlm.nih.gov/pubmed/29021754
http://dx.doi.org/10.3389/fnagi.2017.00307
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