Association of High-Sensitivity Cardiac Troponin I Levels Below Clinical Thresholds With Late-Life Dementia: The Perth Longitudinal Study of Ageing in Women

Toro-Huamanchumo, C., Gebre, A., Pecanha, T., Sale, Craig ORCID: https://orcid.org/0000-0002-5816-4169, Lim, W., Byrnes, E., Lim, E., Laws, S., Zhu, K., Schultz, C., Prince, R., Stephan, B., Siervo, M., Lewis, J. and Sim, M. (2025) Association of High-Sensitivity Cardiac Troponin I Levels Below Clinical Thresholds With Late-Life Dementia: The Perth Longitudinal Study of Ageing in Women. In: Heart, Lung and Circulation, S406. Presented at 73rd Annual Scientific Meeting of the Cardiac Society of Australia and New Zealand, 14 - 17 August 2025, Brisbane, Queensland, Australia.

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Abstract

Aim To examine the association between high-sensitivity cardiac troponin I (hs-cTnI) levels below clinical thresholds and the incidence of late-life dementia (LLD) in older women. Method 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 Aging in 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 (Figure). 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 to 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: 1.22-2.91), hospitalisation (adjusted HR: 1.65, 95% CI: 1.04–2.64) and death (adjusted HR: 2.27, 95% CI: 1.13–4.59). The findings were independent of established cardiovascular and dementia risk factors, including apolipoprotein E (APOE) genotype. Conclusion Among older women, hs-cTnI levels below clinical thresholds for acute coronary syndrome were independently 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.