Background: Recent studies suggest that height is inversely associated with the risk of ischemic stroke and dementia. We tested whether lower stature is associated with cognitive decline in patients with coronary heart disease (CHD).
Patients and Methods: A subset of 363 surviving patients (95.9% males; mean age at baseline 57± 6 yrs.) with CHD who previously participated in a clinical trial (1990-1997) underwent a cognitive and neurovascular status evaluation after a median follow up of 14 yrs. and were reassessed for cognitive function after a median follow up of 20 yrs (mean age at evaluation 77±6.4 yrs). Cognitive function, overall and in specific domains, was assessed using the NeuroTrax Mindstreams Computerized Cognitive Battery. Patients were divided into tertiles of height, assessed at baseline, with cut-off points at ≤168, 169-174 and ≥175 cm. To examine the association between stature and rate of cognitive decline, we used linear mixed effects models. Random intercepts and random slopes were included in all models. All models were adjusted for time and interactions terms of age and time.
Results: Controlling for potential confounders and correcting for multiple comparisons, the bottom tertile of height (as compared to the top tertile) was associated with an increased rate of cognitive decline in a global cognitive score (Standardized β coefficient (β) = -0.37 ± Standard Error (SE) 0.13; P=0.004) and in specific cognitive domains: memory (β= -0.26 ± SE 0.13; P=0.04), executive function (β= -0.25 ± SE 0.12; P=0.040), visual spatial (β= -0.37 ± SE 0.12; P=0.003), non-verbal memory (β= -0.33 ± SE 0.12; P=0.008) and delay non-verbal memory decline (β= -0.42± SE 0.12; P<0.001). Similar associations were observed in sensitivity analyses excluding patients with stroke and dementia.
Conclusion: Lower stature is associated with late cognitive decline among CHD patients.
