{
  "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.Trial registration number ACTRN12617000640303.",
  "authors": [
    {
      "affiliations": [
        "Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia",
        "OBEMET Center for Obesity and Metabolic Health, Lima, Peru",
        "Universidad San Ignacio de Loyola, Lima, Peru"
      ],
      "name": "Carlos J. Toro-Huamanchumo"
    },
    {
      "affiliations": [
        "Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia"
      ],
      "name": "Abadi Kahsu Gebre"
    },
    {
      "affiliations": [
        "Department of Sport and Exercise Sciences, Manchester Metropolitan University Institute of Sport, Manchester Metropolitan University, Manchester, UK"
      ],
      "name": "Tiago Pecanha"
    },
    {
      "affiliations": [
        "Department of Sport and Exercise Sciences, Manchester Metropolitan University Institute of Sport, Manchester Metropolitan University, Manchester, UK"
      ],
      "name": "Craig Sale"
    },
    {
      "affiliations": [
        "Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia",
        "Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia"
      ],
      "name": "Wai Lim"
    },
    {
      "affiliations": [
        "Department of Clinical Biochemistry, Queen Elizabeth II Medical Centre, Nedlands, Western Australia, Australia"
      ],
      "name": "Elizabeth Byrnes"
    },
    {
      "affiliations": [
        "Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia"
      ],
      "name": "Ee Mun Lim"
    },
    {
      "affiliations": [
        "Curtin Medical School, Curtin University, Perth, Western Australia, Australia",
        "Collaborative Genomics and Translation Group, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia",
        "Centre for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia"
      ],
      "name": "Simon Laws"
    },
    {
      "affiliations": [
        "Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia",
        "Medical School, The University of Western Australia, Perth, Western Australia, Australia"
      ],
      "name": "Kun Zhu"
    },
    {
      "affiliations": [
        "Medical School, The University of Western Australia, Perth, Western Australia, Australia",
        "Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia"
      ],
      "name": "Carl Schultz"
    },
    {
      "affiliations": [
        "Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia",
        "Medical School, The University of Western Australia, Perth, Western Australia, Australia"
      ],
      "name": "Richard L Prince"
    },
    {
      "affiliations": [
        "Dementia Centre of Excellence, enAble Institute, Curtin University, Perth, Western Australia, Australia"
      ],
      "name": "Blossom CM Stephan"
    },
    {
      "affiliations": [
        "Dementia Centre of Excellence, enAble Institute, Curtin University, Perth, Western Australia, Australia",
        "School of Population Health, Curtin University, Perth, Western Australia, Australia"
      ],
      "name": "Mario Siervo"
    },
    {
      "affiliations": [
        "Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia",
        "Medical School, The University of Western Australia, Perth, Western Australia, Australia"
      ],
      "name": "Joshua R Lewis"
    },
    {
      "affiliations": [
        "Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia",
        "Medical School, The University of Western Australia, Perth, Western Australia, Australia"
      ],
      "name": "Marc Sim"
    }
  ],
  "title": "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",
  "uid": "13fbf59b-0b41-5d58-8dba-5370158feeeb"
}