medwireNews: Individuals diagnosed with coronary heart disease (CHD) have an increased risk for developing all-cause dementia, Alzheimer’s disease (AD), and vascular dementia in later life, particularly if they are diagnosed before the age of 45 years, finds a study published in the Journal of the American Heart Association.
Wuxiang Xie (Peking University First Hospital, Beijing, China) and colleagues found that among 432,667 individuals studied, the 11.7% with CHD were 36% more likely to develop all-cause dementia over a median 12.8-years of follow-up than the 88.3% of individuals without CHD. The findings were similar for AD and vascular dementia, with respective risk increases of 13% and 78% among CHD patients compared with those without CHD.
The study data were obtained from the UK Biobank. The mean age of the participants was 56.9 years and 54.6% were women. Among the patients with CHD, 21.2% had undergone revascularization or coronary artery bypass grafting.
The researchers also studied the effects of age of CHD onset in a group of 50,445 CHD patients and found it was significantly associated with subsequent dementia risk. The risk for all-cause dementia increased by 25% with each 10-year decrease in age at onset. Patients diagnosed with CHD before the age of 45 years were 71% more likely to develop all-cause dementia than those diagnosed at an age of at least 60 years, while patients diagnosed between the ages of 45 and 59 years were 32% more likely.
The findings were similar for AD and vascular dementia, with a significant 29% and 22% increased risk, respectively, with each 10-year decrease in age at CHD onset.
Xie et al say that “[t]he present findings have important public health implications as they contribute to ascertaining vulnerable populations with dementia by revealing that adults diagnosed with CHD at younger ages, especially before midlife (aged <45years) might be the most vulnerable to future dementia.”
They further explored the association between age at onset of CHD and dementia risk in a propensity score-matched cohort of 50,346 individuals with CHD and an equal number without.
A CHD diagnosis before the age of 45 years was associated with the highest risk for incident dementia, at a significant hazard ratio (HR) of 2.40 compared with no CHD diagnosis. The strength of the association then declined with increasing age at CHD onset, with significant HRs of 1.46 for individuals diagnosed between the ages of 45 and 59 years and 1.11 for those diagnosed at 60 years and older. Again, the findings were similar for incident AD and vascular dementia.
“For clinical practice, our findings suggest, apart from traditional treatment for CHD, additional attention should be paid to the cognitive status of patients with CHD, especially the ones diagnosed with CHD at a young age, during their follow-up visits in health care settings,” the authors comment.
They suggest that “[t]imely intervention, such as cognitive training, could be implemented once signs of cognitive deteriorations are detected.”
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