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 This was true whether patients had suffered a heart attack or they
had angina, which is the term for chest pains caused by reduced
blood flow to the heart.
For about 12 years, researchers followed 7,888 adults, starting when
they were 62 years old on average. At the start, none of them had a
history of stroke, heart attack, angina, or dementia.
By the end of the study, 480 people, or 5.6% of the participants,
had a heart attack or developed angina.
Before these events, and immediately afterward, these patients had
similar annual rates of cognitive decline as participants who didn't
have a heart attack or angina, researchers report in the Journal of
the American College of Cardiology.
But as more time passed after a heart attack or angina diagnosis,
patients experienced more rapid cognitive decline than participants
who didn't have these heart issues. And heart attack and angina
patients also had faster declines in verbal skills, word fluency,
and critical skills like telling time.
"Even a slight acceleration in cognitive decline might speed up
cognitive aging which might eventually translate into problems in
activities of daily living, and finally, to a cause even need for
institutional care," said Suvi Rovio of the University of Turku in
Finland.
"Therefore, the patients who have suffered a cardiovascular event
should be monitored for their cognitive function not only acutely
after the event, but the monitoring should be done frequently and to
be extended to cover a longer time period after the event," Rovio,
coauthor of an editorial accompanying the study.
During the study, researchers assessed participants' cognitive
function in eight waves over up to 12 years.
To test verbal memory, they asked participants to recall 10
unrelated words. They also asked participants to name as many
different animals as possible in one minute, to test semantic
fluency. Third, they asked people questions regarding the date,
month, year and day of the week.
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Participants who experienced a heart attack or angina showed faster
rates of cognitive decline in all 3 tests.
Patients with angina showed a robust decline in cognitive skills
related to time, whereas heart attack patients had significant
cognitive decline in verbal memory and word fluency, and worse
overall cognitive decline.
"Even small differences in cognitive function can result in an
increased risk of dementia in the long-term," said Wuxiang Xie, of
the Imperial College School of Public Health in London and lead
author of the study.
"Because there is no current cure for dementia, early detection and
intervention are essential to delay the progression to dementia,"
Xie said in a statement.
The study wasn't a controlled experiment designed to prove whether
or how a heart attack or angina might directly cause cognitive
decline or accelerate this process. It's possible that coronary
heart disease might cause cognitive decline due to the lack of
oxygen to the brain, the study team write.
One limitation of the study is that it relied on participants to
report any diagnosis of angina or heart attack. Researchers also
measured cognitive function using isolated tasks, and people might
have impairments that went undetected.
Even so, the findings suggest that patients with heart problems need
to be extra careful to make lifestyle changes to minimize their risk
of cognitive decline or dementia in the future, Rovio said.
"This means that it is important for the patients for example to
control their blood pressure and cholesterol levels as well as to
adopt a healthy diet, be physically active, and avoid smoking and
excess alcohol drinking." Rovio advised. "What is known to be good
for your heart is also good for your brain."
SOURCE: http://bit.ly/2x7Js0b Journal of the American College of
Cardiology, online June 17, 2019.
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