Ambulatory recorded ST segment depression on ECG is associated with lower cognitive function in healthy elderly men

Sölve Elmståhl, Linda Furuäng

Department of Health Sciences, Division of Geriatric Medicine, Lund University, Malmö University Hospital, Malmö, Sweden

Abstract: ST segment depression (STDE) has been found to be associated with cardiovascular disease in the elderly. Studies of the relation of ambulatory STDE to cognitive function in elderly persons aged 80 years or above is lacking.

Objective: To study the association between STDE and cognition.

Design and participants: A cross-sectional cohort study of 88 81-year-old men from the population study “Men born in 1914” investigated in an outpatient research clinic. Measurements included ambulatory 24-hour electrocardiogram (ECG) monitoring and a cognitive test battery of six tests. Proportion of lower cognitive function was calculated for each test in relation to STDE during the day and at night-time.

Results: Fifty-eight percent of the men had STDE and a higher proportion with low visuospatial cognitive function was found among those with STDE compared to the others (84% vs 59%; p = 0.014). A significant trend was noted for subjects without STDE compared to STDE night-time less than 60 minutes and night-time more than 60 minutes for spatial and verbal cognitive functions (p = 0.022). No trends were noted for STDE daytime. Maximal STDE during night showed similar association to spatial function (Benton Visual Retention test, r = -0.26; p = 0.028). Even when seven subjects with a history of stroke were excluded, the occurrence of STDE was associated to lower visuospatial cognitive function compared to those without STDE (87% vs 57%; p = 0.004).

Conclusion: ST segment depression on ECG is common among elderly men and might be a vascular risk factor for cognitive deterioration.

Keywords: aged 80 and over, ST segment depression, ambulatory long-term ECG, cognition, cohort study, risk factors