Association of high-sensitivity cardiac troponin I levels below the sex-specific 99th percentile with late-life dementia: The Perth Longitudinal Study of Ageing Women
Author Identifier (ORCID)
Carlos J. Toro-Huamanchumo: https://orcid.org/0000-0002-4664-2856
Abadi Kahsu Gebre: https://orcid.org/0000-0002-1975-0085
Wai Lim: https://orcid.org/0000-0002-3410-3572
Simon Laws: https://orcid.org/0000-0002-4355-7082
Richard L. Prince: https://orcid.org/0000-0002-2298-4202
Joshua R. Lewis: https://orcid.org/0000-0003-1003-8443
Marc Sim: https://orcid.org/0000-0001-5166-0605
Abstract
Background: Elevated high-sensitivity cardiac troponin (hs-cTn) levels are linked with cardiovascular disease and cognitive impairment, both of which are strong risk factors for late-life dementia (LLD). This study examined the association between hs-cTnI levels below the sex-specific 99th percentile for myocardial injury and the incidence of LLD in older women. Methods: 986 community-dwelling women aged ≥70 years without prior LLD and with hs-cTnI < 15.6 ng/L (stratified into quartiles) were included from the Perth Longitudinal Study of Ageing Women. The primary outcome was incident LLD events, including LLD hospitalisation or death, over 14.5 years obtained from linked health records. Associations between hs-cTnI and LLD outcomes were explored using multivariable-adjusted Cox models, as part of restricted cubic splines. Results: At baseline, participants' mean (±SD) age was 75.2±2.7 years. Over 14.5 years of follow-up, LLD events (n=174, 17.7%), hospitalisations (n=155, 15.7%) and deaths (n=68, 6.9%) were recorded. Compared with those in the lowest quartile (Q1, median 3.1 ng/L), women in the highest quartile of hs-cTnI (Q4, median 7.3 ng/L) had a greater risk of developing LLD-related events (adjusted HR: 1.88, 95% CI: 1.22 to 2.91), hospitalisation (adjusted HR: 1.65, 95% CI: 1.04 to 2.64) and death (adjusted HR: 2.27, 95% CI: 1.13 to 4.59), after adjusting for established cardiovascular and dementia risk factors, including apolipoprotein E (APOE) genotype. Conclusion: Among older women, hs-cTnI levels below the sex-specific 99th percentile for myocardial injury were associated with an increased risk of LLD events over 14.5 years. These findings suggest that hs-cTnI may identify older women at higher risk of LLD, capturing both cardiovascular and brain health vulnerability in older age.
Document Type
Journal Article
Date of Publication
1-1-2025
PubMed ID
40830043
Publication Title
Heart
Publisher
BMJ Publishing Group
School
Nutrition and Health Innovation Research Institute / School of Medical and Health Sciences
Funders
National Health and Medical Research Council / Forrest Research Foundation Scholarship / Edith Cowan University / Royal Perth Hospital Research Foundation Career Advancement Fellowship (CAF 130/2020) / Western Australian Future Health Research and Innovation Fund / National Heart Foundation of Australia Future Leader Fellowship (102817, 107323)
Grant Number
NHMRC Numbers : 254627, 303169, 572604
Copyright
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Comments
Toro-Huamanchumo, C. J., Gebre, A. K., Pecanha, T., Sale, C., Lim, W., Byrnes, E., Lim, E. M., Laws, S., Zhu, K., Schultz, C., Prince, R. L., Stephan, B. C., Siervo, M., Lewis, J. R., & Sim, M. (2025). Association of high-sensitivity cardiac troponin I levels below the sex-specific 99th percentile with late-life dementia: The Perth Longitudinal Study of Ageing Women. Heart. Advance online publication. https://doi.org/10.1136/heartjnl-2025-326066