“We are now seeing more issues related to cognitive function from heart disease as more people are living longer, and also undergoing more heart procedures, and placed on medications,” Aggarwal wrote in an email.
The authors of the study say previous research on the issue has been a mixed bag, often focused on the role of conditions like strokes and sometimes showing a more rapid cognitive decline thereafter. But the new study found a longer-term impact on the brain, following up with stroke-free adults for a median of 12 years and looking at a subset who had been diagnosed with a heart attack or angina, a kind of chest pain resulting from decreased flow of blood to the heart.
Heart attack patients “had a significantly faster memory decline than those with an incident angina,” the authors noted.
Whether there could be other external factors is also unclear. For example, the authors note that they couldn’t exclude the potential impact of medications and other treatments that doctors might prescribe to newly diagnosed heart disease patients.
“Teasing out what contributes the most to cognitive decline may be difficult,” Aggarwal said, “as persons with heart disease have multiple medical conditions operating at the same time.
“Medications are a huge factor,” she added — including whether they are taken as prescribed.
Despite the changes in cognitive scores appearing “relatively small,” according to the commentary, the study authors say that “even miniscule differences in cognitive function can result in a substantially increased risk of dementia over several years.” And because no cure exists, they say, finding ways to detect, prevent and intervene early could be our best bet to address the problem, for now.
Aggarwal said there are valuable messages in the study, drawing on her own work at the Cardiology Cognitive Clinic, where her team helps patients address chronic conditions that could take their toll on brain health.
“First step is to encourage patients to tell their physicians about their memory concerns,” Aggarwal said. “Often patients don’t mention this.”
She also encouraged doctors and patients to go over medications and be sure they’re taken as prescribed, to address other possible causes like mood and sleep, and to talk about lifestyle changes that can have a positive effect on overall health.
“What is good for your heart is good for your head,” Aggarwal said.