Table 3.
Additional Adjusted 20‐Year Cognitive Change Associated With Abnormal PWI, Atherosclerosis Risk in Communities Study, 1990–2015
| Cognitive Tests | Normal PTFV1 | Additional Cognitive Change in z Score (95% CI) | |||||
|---|---|---|---|---|---|---|---|
| Abnormal PTFV1 | |||||||
| Model 1 | P Value | Model 2 | P Value | Model 3 | P Value | ||
| DWRT z score | 0 (Ref) | −0.06 (−0.17 to 0.04) | 0.23 | −0.09 (−0.19 to 0.02) | 0.10 | −0.08 (−0.19 to 0.02) | 0.11 |
| DSST z score | 0 (Ref) | −0.01 (−0.05 to 0.03) | 0.67 | −0.03 (−0.08 to 0.01) | 0.13 | −0.03 (−0.08 to 0.01) | 0.13 |
| WFT z score | 0 (Ref) | −0.06 (−0.12 to 0.01) | 0.07 | −0.07 (−0.13 to −0.01) | 0.03 | −0.07 (−0.13 to −0.01) | 0.03 |
| Global z score | 0 (Ref) | −0.04 (−0.11 to 0.03) | 0.22 | −0.07 (−0.13 to −0.01) | 0.04 | −0.07 (−0.13 to −0.01) | 0.04 |
| Normal PWD | PPWD | ||||||
|---|---|---|---|---|---|---|---|
| Model 1 | P Value | Model 2 | P Value | Model 3 | P Value | ||
| DWRT z score | 0 (Ref) | −0.02 (−0.10 to 0.06) | 0.55 | −0.02 (−0.10 to 0.06) | 0.61 | −0.02 (−0.10 to 0.06) | 0.71 |
| DSST z score | 0 (Ref) | −0.01 (−0.05 to 0.03) | 0.65 | −0.01 (−0.04 to 0.03) | 0.82 | −0.01 (−0.04 to 0.04) | 0.94 |
| WFT z score | 0 (Ref) | −0.03 (−0.08 to 0.02) | 0.22 | −0.01 (−0.06 to 0.03) | 0.56 | −0.01 (−0.06 to 0.04) | 0.67 |
| Global z score | 0 (Ref) | −0.03 (−0.08 to 0.02) | 0.24 | −0.02 (−0.07 to 0.03) | 0.51 | −0.01 (−0.06 to 0.04) | 0.65 |
| Normal PWA | Abnormal PWA | ||||||
|---|---|---|---|---|---|---|---|
| Model 1 | P Value | Model 2 | P Value | Model 3 | P Value | ||
| DWRT z score | 0 (Ref) | 0.00 (−0.10 to 0.10) | 0.99 | 0.01 (−0.09 to 0.10) | 0.89 | 0.01 (−0.09 to 0.10) | 0.92 |
| DSST z score | 0 (Ref) | 0.04 (−0.01 to 0.09) | 0.12 | 0.03 (−0.01 to 0.08) | 0.15 | 0.03 (−0.01 to 0.08) | 0.16 |
| WFT z score | 0 (Ref) | −0.01 (−0.06 to 0.06) | 0.88 | −0.03 (−0.08 to 0.03) | 0.39 | −0.02 (−0.08 to 0.03) | 0.41 |
| Global z score | 0 (Ref) | 0.03 (−0.03 to 0.10) | 0.28 | 0.03 (−0.03 to 0.09) | 0.36 | 0.03 (−0.03 to 0.09) | 0.36 |
| No aIAB | aIAB | ||||||
|---|---|---|---|---|---|---|---|
| Model 1 | P Value | Model 2 | P Value | Model 3 | P Value | ||
| DWRT z score | 0 (Ref) | −0.05 (−0.36 to 0.26) | 0.74 | −0.09 (−0.39 to 0.21) | 0.54 | −0.08 (−0.38 to 0.21) | 0.58 |
| DSST z score | 0 (Ref) | 0.15 (−0.01 to 0.29) | 0.06 | 0.10 (−0.04 to 0.23) | 0.15 | 0.10 (−0.03 to 0.24) | 0.13 |
| WFT z score | 0 (Ref) | 0.11 (−0.08 to 0.30) | 0.25 | 0.08 (−0.09 to 0.26) | 0.35 | 0.09 (−0.09 to 0.27) | 0.33 |
| Global z score | 0 (Ref) | 0.12 (−0.08 to 0.31) | 0.23 | 0.07 (−0.11 to 0.25) | 0.45 | 0.08 (−0.11 to 0.26) | 0.41 |
Model 1=adjusted for age (centered at 60 years), sex, race/center, time as a linear spline with a knot at 6 years, age by time spline terms, sex by time spline terms, and race/center by time spline terms. Model 2=Model 1+education, occupation, apolipoprotein E, the time‐dependent variables of smoking, body mass index, systolic blood pressure, diastolic blood pressure, antihypertensive medication, diabetes mellitus, prevalent coronary heart disease, prevalent heart failure, prevalent stroke, plus all these variables by spline terms. Model 3=Model 2 and additionally adjusted for time‐dependent incident stroke and AF. Covariates are updated at visits except for: sex, race, center, education and occupation are from visit 1. A negative estimate indicates a greater cognitive decline in those with aPWI compared with those with normal PWI. This analysis incorporates inverse probability of attrition weights to account for attrition. A negative estimate indicates a greater cognitive decline over the 20‐year period in those with aPWI compared with those with normal PWI. AF indicates atrial fibrillation; aIAB, advanced interatrial block; aPWI, abnormal PWI; DWR, Delayed Word Recall (test of memory); DSS, Digit Symbol Substitution (test of executive function); PPWD, prolonged P‐wave duration; PTFV1, the terminal force of the P wave in ECG lead V1; PWA, P‐wave axis; WF, Word Fluency (test of verbal fluency).