High-sensitivity cardiac troponin I and risk of dementia: 25-year longitudinal study in the Whitehall II cohort

Journal article

Background and Aims This study hypothesises that subclinical myocardial injury during midlife, indexed by increases in cardiac troponin I, is associated with accelerated cognitive decline, smaller structural brain volume, and higher risk of dementia.

Methods 5985 participants in Whitehall II study, aged 45-69 who had cardiac troponin I measured by a high-sensitivity assay at baseline (1997-99), were followed until March 2023. The outcome measure was incident dementia; cognitive testing performed at six waves; and neuroimaging metrics from magnetic resonance imaging scans at 2012-16. Cox model and linear mixed model were used to examine the association of cardiac troponin with incident dementia and cognitive trajectory. A nested case-control sample of 3475 participants (695 dementia cases and 2780 matched controls) was used for backward trajectory analysis for cardiac troponin, measured at three waves (1997-99, 2007-09, 2012-13).

Results 606 (10.1%) cases of dementia were recorded over a median follow-up of 24.8 years. Doubling of cardiac troponin was associated with 10% (95%CI: 3-17%) higher risk of dementia. Participants with increased cardiac troponin at baseline had a faster decline of cognitive function. Participants with dementia had increased cardiac troponin concentrations compared with those without dementia between 7 and 25 years before diagnosis. Compared to those with cardiac troponin levels <2.5 ng/L at baseline, those with concentrations >5.2 ng/L had lower grey matter volume and higher hippocampal atrophy 15 years later, equivalent to ageing effects of 2.7 and 3 years, respectively.

Conclusions Subclinical myocardial injury at midlife was associated with higher dementia risk in later life.

Authors: Chen, Y; Shipley, M; Anand, A; Kimenai, DM; Ebmeier, KP

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Oxford University Press
• Journal: European Heart Journal
• Article number: ehaf834
• Publication date: 2025-11-06
• Acceptance date: 2025-09-30
• DOI: 10.1093/eurheartj/ehaf834
• EISSN: 1522-9645
• ISSN: 0195-668X
• Language: English
• Keywords: myocardial injury; troponin; dementia; cognitive decline