Cognitive Decline

Cognitive decline; Adults with incident coronary heart disease (CHD) are at higher risk for faster cognitive decline in the long-term, according to a study published today in the Journal of the American College of Cardiology. Coronary heart disease (CHD) is the leading cause of death in men and women. CHD occurs when coronary arteries become damaged due to a build-up of fat and cholesterol and can result in a heart attack or angina when the heart cannot get the blood or oxygen it needs.

Three cognitive tests were use to assess participants’ cognitive function in eight waves across a 12-year follow-up period. First, verbal memory was asses by testing immediate; also delay recall of 10 unrelate words. Second, participants were asked to orally name as many different; so animals as possible in one minute to test semantic fluency. Third, temporal orientation was assessed through four questions regarding the current date. Higher scores indicate better cognitive function.

Patients diagnosed with angina

During the study period, 5.6 percent of participants experience a heart attack or angina. Those with CHD show faster rates of cognitive decline in all three tests. Patients diagnose with angina show a robust decline in temporal orientation; so whereas heart attack patients had significant cognitive decline; so in verbal memory and semantic fluency, and worse overall cognitive decline.

Even small differences in cognitive function can result in an increase risk of dementia in the long-term; said Wuxiang Xie, Ph.D., the study’s lead author and a research fellow at the Imperial College School of Public Health in London. Because there is no current cure for dementia; so early detection and intervention are essential to delay the progression to dementia. Heart attack and angina patients need careful monitoring in the years following a diagnosis.

The researchers report that CHD might directly contribute to cognitive decline due to the lack of oxygen to the brain. A previous study determine ischemic heart disease was with cerebral microinfarcts, suggesting that CHD may be associate with cerebral small vessel disease a leading cause dementia in older adults—and therefore contributes to cognitive impairment.

Clinical cognitive impairment

In an accompanying editorial comment, Suvi P. Rovio, Ph.D., adjunct professor at the University of Turku Research Centre of Apply and Preventive Cardiovascular Medicine in Finland, said the links between cardiovascular and brain health suggest that compromise cardiovascular risk factor levels from early age may damage both vascular and neural tissues of the brain.

This study provides evidence on the role of incident coronary heart disease as a possible factor bending the course of cognitive decline trajectory in older age, she said. While primordial and primary prevention would be the most optimal outlooks to postpone clinical cognitive impairment, it is crucial to identify specific at-risk populations for target secondary and tertiary prevention.

This study has several limitations, including the use of self-report doctor-diagnose incident CHD, as well as a lack of accurate information on the date of CHD diagnosis, symptom severity, acute treatments and medications. Another limitation includes measuring cognitive function using isolate tasks. Further research is warrant to determine the exact link between incident CHD and cognitive decline through elaborate and comprehensive assessment.