Does a heart attack make your brain older?
Hearts and minds share a health connection, and a recent study suggests taking care of your heart may help stave off symptoms of dementia in later life.
An analysis published May 30, 2023 in JAMA Neurology found an association between having a heart attack and faster cognitive decline years later. The analysis examined information from six large long-term studies done from 1971 to 2019. These studies provided data on 30,465 individuals with a mean age of 64, who initially had no history of heart attack, stroke or dementia.
During the time periods in which they were followed, 1,033 participants had one or more heart attacks (myocardial infarctions). Those people showed no immediate loss in brain function, but they experienced faster mental decline with age than those who didn’t have a heart attack – the equivalent of six to 13 additional years of aging, according to a Johns Hopkins University article on the analysis.
Falmouth cardiologist Jennifer H. Ladner, MD, FACC, said she is not surprised by the results of the analysis.
“We know the risk factors for dementia are similar to those for heart attacks,” she said. “If a person has a heart attack, it really accelerates the rate of cognitive decline.”
The recent analysis is important because “it is another carrot to get people to get their cholesterol under control, and their hypertension (high blood pressure), diabetes, smoking, exercise and sedentary lifestyle,” she said.
The lead researchers on the review were from Johns Hopkins University School of Medicine in Baltimore, MD, and the University of Michigan Medical School in Ann Arbor, MI.
The analysis measured mental abilities in three categories: global cognition, executive function and memory. Global cognition showed the biggest rate of decline years after a heart attack. White men showed more decline in global cognition after a heart attack than women or Black men.
Plaque: Bad for Heart and Brain
Heart attacks occur when blood flow to a portion of the heart is partially or fully blocked, causing muscle in that area to die. Atherosclerosis, the buildup of plaque on the inner walls of arteries, causes diseases that together constitute the leading cause of death in the United States, according to the National Heart, Lung and Blood Institute. Plaque can reduce or block blood flow, and breaks in plaque can create clots that block flow or be carried to other sites, causing a stroke or heart attack.
Atherosclerosis and high blood pressure play significant roles in 25-50 percent of dementia cases, the Institute says, and often exist in combination with Alzheimer’s disease or other dementias. Vascular dementia results when damaged blood vessels prevent the brain from getting enough oxygenated blood.
Arterial plaque accumulates from mixed deposits of cholesterol and other fatty substances, cellular wastes, clotting material and calcium, according to the American Heart Association. Plaque may start to form when the inside of arteries is injured by diabetes, smoking, high blood pressure or high blood levels of triglycerides and cholesterol.
Quality of Life Issue
Paying attention to your cardiovascular health is not just to prevent a heart attack, said Dr. Ladner, but to promote a better quality of life in later years.
She said more research may identify the mechanisms responsible for the increased risk of earlier onset of dementia in old age, which could provide targets for treatment. Scientists could then be “looking for drugs to modify the risks,” she said.
