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.

Keywords

Biomarkers, cardiovascular diseases, cohort studies

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

Funding Information

The study was supported by project grants 254627, 303169 and 572604 from the National Health and Medical Research Council of Australia. CT-H is supported by the Forrest Research Foundation Scholarship and the ECU Higher Degree by Research Scholarship. MSim received support from the Royal Perth Hospital Research Foundation Career Advancement Fellowship (CAF 130/2020) and an Emerging Leader Fellowship from the Western Australian Future Health Research and Innovation Fund. JRL is supported by a National Heart Foundation of Australia Future Leader Fellowship (ID: 102817 and 107323). This work was made possible through Dementia Australia's support of their Chair of Dementia (author BCMS).

Funding received from the National Health and Medical Research Council (NHMRC)

254627, 303169, 572604

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

Comments

This article has been accepted for publication in Heart, 2025, following peer review, and the Version of Record can be accessed online at https://doi.org/10.1136/heartjnl-2025-326066

© Authors (or their employer(s)) 2025

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

Recommended Citation

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

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Link to publisher version (DOI)

10.1136/heartjnl-2025-326066