Study: Heart Disease Risk Associated With Cognitive Decline

A study found that individuals with a higher risk of developing cardiovascular disease (CVD) showed increased cognitive decline, including an increase in typical markers of Alzheimer disease, and indicated that monitoring for and controlling heart disease may lead to maintaining and improving cognitive health later in life.

Fifty million individuals were diagnosed with dementia in 2017, and the World Health Organization predicted 50 million cases by 2030. As there is no effective treatment currently, it remains imperative to identify and minimize risk factors.

Previous findings have recognized the relationship between CVD risk factors and various brain regions, including white matter, gray matter and hippocampus, though results were largely inconsistent.

The study, published in the Journal of the American College of Cardiology, incorporated 1588 dementia-free participants from the Rush Memory and Aging Project, and followed them for 21 years. Investigators evaluated the Patients’ Framingham General Cardiovascular Risk Score (FGRS) at baseline, and subsequently categorized into lowest, middle, or highest according to the individual’s risk for heart disease.

Researchers assessed the following through 19 different tests:

• Episodic memory (memory of everyday events)
• Semantic memory (long-term memory)
• Working memory (short-term memory)
• Visuospatial ability (capacity to identify visual and spatial relationships among objects)
• Perceptual speed (ability to accurately and completely compare letters, numbers, objects, pictures or patterns)

Results showed that higher cardiovascular risk burden was associated with speedier decline in episodic memory, working memory, and perceptual speed. MRI data was also used for a category of patients and found that higher FGCRS led to smaller volumes of hippocampus, cortical gray matter, and total brain. Decreases in hippocampal and gray matter often are signs of neurodegeneration.

"In the absence of effective treatments for dementia, we need to monitor and control cardiovascular risk burden as a way to maintain patient's cognitive health as they age," said Weili Xu, PhD, Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China. "Given the progressive increase in the number of dementia cases worldwide, our findings have both clinical and public health relevance."

References:

1. Xu W, Song R, Xu H, et al. Associations between cardiovascular risk, structural brain changes, and cognitive decline. Journal of the American College of Cardiology. 2020. doi 10.1016/j.jacc.2020.03.053
2. Maintaining heart health may protect against cognitive decline. News Release. American College of Cardiology; May 18, 2020. Accessed May 19, 2020. https://www.eurekalert.org/pub_releases/2020-05/acoc-mhh051420.php