According to a new study published in the Journal of the American College of Cardiology, those who have suffered a heart attack or angina may show accelerated signs of cognitive decline. This was one of the most extensive longitudinal studies investigating the progression of cognitive decline before and after coronary heart disease.
Coronary heart disease (CHD) is listed as the leading cause of death in men and women. CHD is the outcome when coronary arteries become damaged because of a build-up of fat and cholesterol. This can result in a heart attack or angina when the heart can’t get the oxygen or blood it needs to function correctly.
The study included data from a total of 7,888 stroke-free participants from the English Longitudinal Study of Aging (ELSA), a community based biannual cohort study that included adults aged 50 years and older from 2002-2017. Participants who had a history of stroke, heart attack, angina, dementia, or Alzheimer’s were excluded from the study.
Researchers used three cognitive tests to assess participants cognitive function in eight waves across a 12-year follow-up period. First, verbal memory was tested using immediate and delayed recall of 10 unrelated words. Second, participants were requested to orally name as many different animals as possible in one minute to test semantic fluency. The third test included temporal orientation through four questions regarding the current date. Higher scores indicated better cognitive function.
The study found that during the period of research, 5.6 percent of participants experienced a heart attack or angina. Those with CHD showed accelerated signs of cognitive decline in all three tests. Patients diagnosed with angina had a decline in temporal orientation, and those who had suffered a heart attack had a significant cognitive decline in semantic fluency, verbal memory, and had overall worse cognitive decline.
The researchers reported that cognitive decline after CHD might be directly due to the lack of oxygen to the brain. A previous study has determined that ischemic heart disease was associated with cerebral microinfarcts. This suggests that CHD may be associated with cerebral small vessel disease, a leading cause of dementia in older adults which contributes to cognitive impairment.
It was noted that there was no association found between cognitive decline and pre-CHD-diagnosis. There was also no reported short-term cognitive decline after the CHD event occurred.
Wuxiang Xie, Ph.D., the study’s lead author and a research fellow at the Imperial College School of Public Health in London spoke about the study, “Even small differences in cognitive function can result in an increased risk of dementia in the long-term. Because there is no current cure for dementia, 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.”
An accompanying editorial to the study was written by, Suvi P. Rovio, Ph.D., adjunct professor at the University of Turku Research Centre of Applied and Preventive Cardiovascular Medicine in Finland. It was stated that “The links between cardiovascular and brain health suggest that compromised 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. 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 targeted secondary and tertiary prevention.”
Further research is needed to determine the exact link between coronary heart disease and cognitive decline, but this study does act as a reminder that primary prevention is the best solution to cut the risk of cognitive decline after heart attack or angina.
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