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Published on: March 27, 2018
Coronary Artery Bypass Graft Surgery and Dementia Risk in the Cardiovascular Health Study
Elżbieta Kuźma1, Jac Airdrie, Thomas J Littlejohns
1*Institute of Health Research, University of Exeter Medical School, Exeter †School of Psychology, Cardiff University, Cardiff ‡Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK §Department of Health Science, Brigham Young University, Provo, UT Departments of ∥Epidemiology **Neurology, University of Washington, Seattle, WA Departments of ¶Epidemiology #Neurology and Psychiatry, University of Pittsburgh, Pittsburgh, PA.
Insights
History of coronary artery bypass graft (CABG) surgery is linked to a higher long-term risk of dementia. This association was observed in elderly adults and warrants further investigation into underlying causes.
Area of Science:
- Neurology
- Cardiology
- Geriatrics
Background:
- The relationship between coronary artery bypass graft (CABG) surgery and dementia risk is not well-established.
- Understanding this association is crucial for managing long-term cognitive health in surgical patients.
Purpose of the Study:
- To investigate the association between a history of CABG surgery and the risk of developing dementia in elderly adults.
- To analyze the risk for all-cause dementia, Alzheimer disease, vascular dementia, and mixed dementia.
Main Methods:
- Prospective cohort analysis of 3155 elderly adults from the Cardiovascular Health Study (CHS).
- Adjudicated assessment of incident all-cause dementia, Alzheimer disease (AD), vascular dementia (VaD), and mixed dementia.
- Findings were pooled with a prior prospective study for enhanced statistical power.
Main Results:
- History of CABG surgery was associated with a 93% increased hazard ratio (HR) for all-cause dementia (HR=1.93).
- Elevated HRs were observed for Alzheimer disease (HR=1.71), vascular dementia (HR=1.42), and mixed dementia (HR=2.73).
- Pooled analysis confirmed an increased risk for all-cause dementia (HR=1.96) and AD (HR=1.71).
Conclusions:
- A history of CABG surgery is associated with an increased long-term risk of dementia.
- Further research is needed to elucidate the causal mechanisms, such as coronary artery disease severity.
Introduction:
The association between history of coronary artery bypass graft surgery (CABG) and dementia risk remains unclear.
Methods:
We conducted a prospective cohort analysis using data on 3155 elderly adults free from prevalent dementia from the US population-based Cardiovascular Health Study (CHS) with adjudicated incident all-cause dementia, Alzheimer disease (AD), vascular dementia (VaD), and mixed dementia.
Results:
In the CHS, the hazard ratio (HR) for all-cause dementia was 1.93 [95% confidence interval (CI), 1.36-2.74] for those with CABG history compared with those with no CABG history after adjustment for potential confounders. Similar HRs were observed for AD (HR=1.71; 95% CI, 0.98-2.98), VaD (HR=1.42; 95% CI, 0.56-3.65), and mixed dementia (HR=2.73; 95% CI, 1.55-4.80). The same pattern of results was observed when these CHS findings were pooled with a prior prospective study, the pooled HRs were 1.96 (95% CI, 1.42-2.69) for all-cause dementia, 1.71 (95% CI, 1.04-2.79) for AD and 2.20 (95% CI, 0.78-6.19) for VaD.
Discussion:
Our results suggest CABG history is associated with long-term dementia risk. Further investigation is warranted to examine the causal mechanisms which may explain this relationship or whether the association reflects differences in coronary artery disease severity.
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