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Heart failure and risk of dementia and Alzheimer disease: a population-based cohort study

Chengxuan Qiu1, Bengt Winblad, Alessandra Marengoni

  • 1Aging Research Center, Division of Geriatric Epidemiology and Medicine, Department of Neurotec, Karolinska Institutet and Stockholm Gerontology Research Center, Olivecronas väg 4, S-113 82 Stockholm, Sweden. chengxuan.qiu@ki.se

Archives of Internal Medicine
|May 10, 2006
PubMed

Insights

Heart failure significantly increases the risk of developing dementia and Alzheimer disease in older adults. Early antihypertensive treatment may help mitigate this increased dementia risk associated with heart failure.

Area of Science:

  • Cardiology
  • Neurology
  • Geriatrics

Background:

  • Previous studies linked heart failure to cognitive impairment.
  • No prior research investigated heart failure as a risk factor for dementia.
  • This study examined heart failure's role in dementia and Alzheimer's disease development.

Purpose of the Study:

  • To determine if heart failure is a risk factor for dementia.
  • To assess the association between heart failure and Alzheimer disease risk.

Main Methods:

  • A 9-year longitudinal study of 1301 elderly individuals (≥75 years) without dementia in Stockholm.
  • Dementia and Alzheimer disease diagnosed using DSM-IV criteria.
  • Heart failure diagnosed via clinical signs, inpatient records, and cardiac medication use.
  • Cox proportional hazards models used for data analysis, adjusting for confounders.

Main Results:

  • Over 6534 person-years, 440 participants developed dementia (333 Alzheimer disease).
  • Heart failure at baseline was linked to a 1.84-fold increased dementia risk (HR 1.84; 95% CI, 1.35-2.51).
  • Antihypertensive drugs, particularly diuretics, and low diastolic pressure (<70 mmHg) modified dementia risk.

Conclusions:

  • Heart failure is an independent risk factor for dementia and Alzheimer disease in the elderly.
  • Antihypertensive therapy may offer a protective effect against dementia in heart failure patients.
  • Combined heart failure and low diastolic pressure significantly elevate dementia risk.
Abstract

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