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Cognitive impairment among elderly coronary heart disease patients
M Ahto1, R Isoaho, H Puolijoki
1Unit of General Practice, Oulu University Hospital and Department of Public Health Science and General Practice, University of Oulu, Finland.merja.ahto@utu.fi
Insights
Coronary heart disease (CHD) does not independently affect cognitive function in the elderly. However, complicated CHD in men may negatively impact cognitive abilities, particularly in orientation and language.
Area of Science:
- Gerontology
- Cardiology
- Neurology
Background:
- Coronary heart disease (CHD) and cognitive decline are prevalent in the elderly.
- Cardiovascular diseases (CVDs) are linked to vascular dementia, but the relationship between CHD and general cognitive function in older adults requires further population-based study.
Purpose of the Study:
- To investigate the association between coronary heart disease (CHD) and cognitive impairment in an elderly population.
Main Methods:
- The Lieto study population included community-dwelling men and women aged 64 years and older.
- Patients with CHD (defined by angina pectoris or myocardial infarction) were compared to age- and sex-matched controls without CHD.
- Cognitive function was assessed using the Mini-Mental State Examination (MMSE).
Main Results:
- No significant differences in overall cognitive functioning (total MMSE scores or subtest scores) were observed between elderly patients with CHD and controls.
- In men, higher MMSE scores in orientation and language correlated with more severe chest pain.
- Logistic regression indicated that cognitive impairment in men was associated with advanced age, cardiac glycoside use, and physical disability. In women, cognitive impairment was linked to advanced age and antipsychotic use.
Conclusions:
- Coronary heart disease (CHD) generally shows no independent association with cognitive impairment in non-institutionalized, community-living elderly individuals.
- A complex or severe form of CHD may negatively influence cognitive functioning in elderly men.
Background:
Coronary heart disease (CHD) and decline in cognitive functioning and dementia are common problems in the elderly. Cardiovascular diseases (CVDs) are connected with vascular dementia, but less is known about cognitive functioning among elderly patients with CHD based on population studies.
Objective:
To describe the associations between CHD and cognitive impairment among the elderly.
Population And Methods:
Of the total population of the Lieto study (488 community-dwelling men and 708 women, >/=64 years old), the ambulatory patients with CHD (89 men and 73 women) and sex- and age-matched controls without any sign of CHD (178 men and 146 women) were selected to make up the study population. CHD was defined as the presence of angina pectoris or a past myocardial infarction. Cognitive assessment was based on the Mini-Mental State Examination (MMSE).
Results:
The total MMSE scores, the MMSE subtest scores and the overall test-based cognitive functioning did not differ between patients and controls. Among men, higher MMSE subscores in orientation and language were related to more severe chest pain. According to logistic regression analyses, the cognitive impairment of men was associated with high age, the use of cardiac glycosides and physical disability. Among women, cognitive impairment was associated with high age and the use of antipsychotics.
Conclusion:
In general, CHD has no independent association with cognitive impairment among the non-institutionalized community-living elderly. Among men, however, a complicated CHD may negatively affect cognitive functioning.