The Impact of Heart Disease On Brain Function
Correlation of heart disease and memory problems is real and should be addressed, says Cleveland Clinic expert.
The implication heart disease has on one’s body is undeniable, but the reality is that women are susceptible to mental impairment from the disease as well.
While researchers throughout the last decade have recognized the association between heart disease and mild cognitive impairment (MCI) in women, it is becoming more clear that there is an unequal increased risk of cognitive decline for one gender over the other, according to Cleveland Clinic neurologist, Irene Katzan, MD, MS.
A recent report adds fuel to the neurological impairment – heart disease connection. In a large population-based study published in JAMA Neurology (January 2013), researchers found that among women aged 70 to 89 years a history of cardiac disease was strongly associated with an increased risk of developing non-amnestic mild cognitive impairment. The association was less obvious among the older men in the study.
Within the study, cardiac disease was defined as a diagnosis of atrial fibrillation, coronary heart disease or congestive heart failure. The physical and neuropsychological evaluations included assessment using the Clinic Dementia Rating Scale, Functional Activities Questionnaire, Short Test of Mental Status, and nine tests examining memory, executive function, language and visuospatial skills. Follow-up assessments among women study participants with heart disease showed the hazard ratio for non-amnestic MCI was 3.07. In contrast, men with cardiac disease had an insignificant 1.16 hazard ratio compared with men who did not have cardiac disease.
Findings from the study support the hypothesis that non-amnestic mild cognitive impairment has a vascular etiology, write the study’s authors.
The vascular risk factors that affect the arteries in the heart are the same as those that affect the arteries in the head and may be the potential reason why memory loss occurs in patients with cardiovascular disease, explains Dr. Katzan of Cleveland Clinic’s Cerebrovascular Center
“It’s important to note that some patients with cardiac disease may have had strokes in the past,” Dr. Katzan says. “Even if they haven’t had frank ‘clinical’ strokes, they may have narrowing of arteries or small platelet plugs that might ultimately cause cognitive problems.”
Mild cognitive impairment is defined as the transition between normal aging and dementia. Amnestic MCI affects memory and is often a precursor to Alzheimer’s disease. Comparatively, non-amnestic MCI impairs language, visuospatial awareness and attention.
“Vascular dementia is more commonly linked to non-amnestic memory problems, and there isn’t as clear a progression to Alzheimer’s disease from this type of cardiovascular caused mental impairment,” explains Dr. Katzan. “By understanding non-amnestic MCI’s presence purely from stroke, or prior to a stroke due to vascular changes, we can do more than control the medical issues in women with cardiovascular disease.”
Knowledge is Power
For women who have heart disease, or those who are at increased risk, Dr. Katzan recommends they talk with their physician about the toll it may have on their mental ability.
“While there isn’t a medication to prevent or fix cognitive decline in women with heart disease, there are steps to control your risk factors of heart disease and the impact on one’s mind,” she says.
Preventing progression of heart disease by controlling high blood pressure and high cholesterol with diet and exercise is the same path recommended for preserving mental acuity. Purely being active both physically and mentally helps both the body and mind, and some studies suggest that brain exercises can potentially slow the progression to Alzheimer’s disease.
Recent research published in the Journal of Neurology, Neurosurgery and Psychiatry, found that following a Mediterranean-style diet that emphasizes fruits, vegetables, whole grains, fish, nuts and olive oil (and little red meat and sweets), helped improve cardiovascular health and lowered the risk of memory loss for men and women. “As more studies strengthen the link between the brain and heart disease, it’s becoming more important that you control your risk factors. The risk of cardiovascular disease and memory problems is real, and women in particular should be proactive in the overall health,” Dr. Katzan says.