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September 30, 2014; 83 (14) Article

ABO blood type, factor VIII, and incident cognitive impairment in the REGARDS cohort

Kristine S. Alexander, Neil A. Zakai, Sarah Gillett, Leslie A. McClure, Virginia Wadley, Fred Unverzagt, Mary Cushman
First published September 10, 2014, DOI: https://doi.org/10.1212/WNL.0000000000000844
Kristine S. Alexander
From the Departments of Medicine (K.S.A., N.A.Z., S.G., M.C.) and Pathology (N.A.Z., M.C.), University of Vermont, Burlington; School of Public Health (L.A.M.) and Division of Gerontology, Geriatrics and Palliative Care, Department of Medicine (V.W.), University of Alabama at Birmingham; and Department of Psychiatry (F.U.), Indiana University School of Medicine, Indianapolis.
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Neil A. Zakai
From the Departments of Medicine (K.S.A., N.A.Z., S.G., M.C.) and Pathology (N.A.Z., M.C.), University of Vermont, Burlington; School of Public Health (L.A.M.) and Division of Gerontology, Geriatrics and Palliative Care, Department of Medicine (V.W.), University of Alabama at Birmingham; and Department of Psychiatry (F.U.), Indiana University School of Medicine, Indianapolis.
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Sarah Gillett
From the Departments of Medicine (K.S.A., N.A.Z., S.G., M.C.) and Pathology (N.A.Z., M.C.), University of Vermont, Burlington; School of Public Health (L.A.M.) and Division of Gerontology, Geriatrics and Palliative Care, Department of Medicine (V.W.), University of Alabama at Birmingham; and Department of Psychiatry (F.U.), Indiana University School of Medicine, Indianapolis.
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Leslie A. McClure
From the Departments of Medicine (K.S.A., N.A.Z., S.G., M.C.) and Pathology (N.A.Z., M.C.), University of Vermont, Burlington; School of Public Health (L.A.M.) and Division of Gerontology, Geriatrics and Palliative Care, Department of Medicine (V.W.), University of Alabama at Birmingham; and Department of Psychiatry (F.U.), Indiana University School of Medicine, Indianapolis.
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Virginia Wadley
From the Departments of Medicine (K.S.A., N.A.Z., S.G., M.C.) and Pathology (N.A.Z., M.C.), University of Vermont, Burlington; School of Public Health (L.A.M.) and Division of Gerontology, Geriatrics and Palliative Care, Department of Medicine (V.W.), University of Alabama at Birmingham; and Department of Psychiatry (F.U.), Indiana University School of Medicine, Indianapolis.
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Fred Unverzagt
From the Departments of Medicine (K.S.A., N.A.Z., S.G., M.C.) and Pathology (N.A.Z., M.C.), University of Vermont, Burlington; School of Public Health (L.A.M.) and Division of Gerontology, Geriatrics and Palliative Care, Department of Medicine (V.W.), University of Alabama at Birmingham; and Department of Psychiatry (F.U.), Indiana University School of Medicine, Indianapolis.
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Mary Cushman
From the Departments of Medicine (K.S.A., N.A.Z., S.G., M.C.) and Pathology (N.A.Z., M.C.), University of Vermont, Burlington; School of Public Health (L.A.M.) and Division of Gerontology, Geriatrics and Palliative Care, Department of Medicine (V.W.), University of Alabama at Birmingham; and Department of Psychiatry (F.U.), Indiana University School of Medicine, Indianapolis.
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Citation
ABO blood type, factor VIII, and incident cognitive impairment in the REGARDS cohort
Kristine S. Alexander, Neil A. Zakai, Sarah Gillett, Leslie A. McClure, Virginia Wadley, Fred Unverzagt, Mary Cushman
Neurology Sep 2014, 83 (14) 1271-1276; DOI: 10.1212/WNL.0000000000000844

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Abstract

Objective: To assess the relationships among ABO group, factor VIII (FVIII), and incident cognitive impairment in a large, prospective cohort study of black and white adults in the United States using a nested case-control design.

Methods: Incident cognitive impairment was defined using cognitive domain tests over a mean follow-up of 3.4 years. ABO blood group was measured by genotyping in a nested case-control sample of 495 cases with cognitive impairment and 587 controls.

Results: Those with blood group AB and those with higher FVIII had an increased risk of cognitive impairment, adjusting for age, race, region, and sex (respective odds ratios 1.82, 95% confidence interval [CI] 1.15–2.90; and 1.24, 95% CI 1.10–1.38 for 40 IU/dL higher FVIII). Mean FVIII was higher in those with blood type AB (142 IU/dL; 95% CI 119–165) compared with O (104 IU/dL; 95% CI 101–107), and FVIII mediated 18% of the association between AB group and incident cognitive impairment (95% CI for mediation −30% to 68%).

Conclusions: Blood group AB and higher FVIII were associated with increased incidence of cognitive impairment in this prospective study. The association of blood group AB with incident cognitive impairment was not significantly mediated by FVIII levels.

GLOSSARY

CHD=
coronary heart disease;
CI=
confidence interval;
CVD=
cardiovascular disease;
FVIII=
factor VIII;
REGARDS=
Reasons for Geographic and Racial Differences in Stroke;
SNP=
single nucleotide polymorphism;
vWF=
von Willebrand factor

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Received April 17, 2014.
  • Accepted in final form July 3, 2014.
  • © 2014 American Academy of Neurology
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