Coronary heart disease, heart failure, and the risk of dementia: A systematic review and meta-analysis

Cardiovascular risk factors are closely linked with dementia risk, but whether heart disease predisposes to dementia is uncertain. We systematically reviewed the literature and meta-analyzed risk estimates from longitudinal studies reporting the association of coronary heart disease (CHD) or heart f...

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Published in:	Alzheimer's & dementia Vol. 14; no. 11; p. 1493
Main Authors:	Wolters, Frank J, Segufa, Reffat A, Darweesh, Sirwan K L, Bos, Daniel, Ikram, Mohammad Arfan, Sabayan, Behnam, Hofman, Albert, Sedaghat, Sanaz
Format:	Journal Article
Language:	English
Published:	United States 01.11.2018
Subjects:	Heart failure Myocardial infarction Alzheimer's disease Coronary heart disease Dementia
ISSN:	1552-5279, 1552-5279
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Abstract	Cardiovascular risk factors are closely linked with dementia risk, but whether heart disease predisposes to dementia is uncertain. We systematically reviewed the literature and meta-analyzed risk estimates from longitudinal studies reporting the association of coronary heart disease (CHD) or heart failure (HF) with risk of dementia. We identified 16 studies (1,309,483 individuals) regarding CHD, and seven studies (1,958,702 individuals) about HF. A history of CHD was associated with a 27% increased risk of dementia (pooled relative risk [RR] [95% confidence interval, CI]: 1.27 [1.07-1.50]), albeit with considerable heterogeneity across studies (I = 80%). HF was associated with 60% increased dementia risk (pooled RR 1.60 [1.19-2.13]) with moderate heterogeneity (I = 59%). Among prospective population-based cohorts, pooled estimates were similar (for CHD, RR 1.26 [1.06-1.49], nine studies; and HF, RR 1.80 [1.41-2.31], four studies) and highly consistent (I = 0%). CHD and HF are associated with an increased risk of dementia.
AbstractList	Cardiovascular risk factors are closely linked with dementia risk, but whether heart disease predisposes to dementia is uncertain.INTRODUCTIONCardiovascular risk factors are closely linked with dementia risk, but whether heart disease predisposes to dementia is uncertain.We systematically reviewed the literature and meta-analyzed risk estimates from longitudinal studies reporting the association of coronary heart disease (CHD) or heart failure (HF) with risk of dementia.METHODSWe systematically reviewed the literature and meta-analyzed risk estimates from longitudinal studies reporting the association of coronary heart disease (CHD) or heart failure (HF) with risk of dementia.We identified 16 studies (1,309,483 individuals) regarding CHD, and seven studies (1,958,702 individuals) about HF. A history of CHD was associated with a 27% increased risk of dementia (pooled relative risk [RR] [95% confidence interval, CI]: 1.27 [1.07-1.50]), albeit with considerable heterogeneity across studies (I2 = 80%). HF was associated with 60% increased dementia risk (pooled RR 1.60 [1.19-2.13]) with moderate heterogeneity (I2 = 59%). Among prospective population-based cohorts, pooled estimates were similar (for CHD, RR 1.26 [1.06-1.49], nine studies; and HF, RR 1.80 [1.41-2.31], four studies) and highly consistent (I2 = 0%).RESULTSWe identified 16 studies (1,309,483 individuals) regarding CHD, and seven studies (1,958,702 individuals) about HF. A history of CHD was associated with a 27% increased risk of dementia (pooled relative risk [RR] [95% confidence interval, CI]: 1.27 [1.07-1.50]), albeit with considerable heterogeneity across studies (I2 = 80%). HF was associated with 60% increased dementia risk (pooled RR 1.60 [1.19-2.13]) with moderate heterogeneity (I2 = 59%). Among prospective population-based cohorts, pooled estimates were similar (for CHD, RR 1.26 [1.06-1.49], nine studies; and HF, RR 1.80 [1.41-2.31], four studies) and highly consistent (I2 = 0%).CHD and HF are associated with an increased risk of dementia.CONCLUSIONCHD and HF are associated with an increased risk of dementia. Cardiovascular risk factors are closely linked with dementia risk, but whether heart disease predisposes to dementia is uncertain. We systematically reviewed the literature and meta-analyzed risk estimates from longitudinal studies reporting the association of coronary heart disease (CHD) or heart failure (HF) with risk of dementia. We identified 16 studies (1,309,483 individuals) regarding CHD, and seven studies (1,958,702 individuals) about HF. A history of CHD was associated with a 27% increased risk of dementia (pooled relative risk [RR] [95% confidence interval, CI]: 1.27 [1.07-1.50]), albeit with considerable heterogeneity across studies (I = 80%). HF was associated with 60% increased dementia risk (pooled RR 1.60 [1.19-2.13]) with moderate heterogeneity (I = 59%). Among prospective population-based cohorts, pooled estimates were similar (for CHD, RR 1.26 [1.06-1.49], nine studies; and HF, RR 1.80 [1.41-2.31], four studies) and highly consistent (I = 0%). CHD and HF are associated with an increased risk of dementia.
Author	Segufa, Reffat A Wolters, Frank J Bos, Daniel Ikram, Mohammad Arfan Hofman, Albert Sabayan, Behnam Darweesh, Sirwan K L Sedaghat, Sanaz
Author_xml	– sequence: 1 givenname: Frank J surname: Wolters fullname: Wolters, Frank J email: f.j.wolters@erasmusmc.nl organization: Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Neurology, Erasmus Medical Centre, Rotterdam, The Netherlands. Electronic address: f.j.wolters@erasmusmc.nl – sequence: 2 givenname: Reffat A surname: Segufa fullname: Segufa, Reffat A organization: Department of Gerontology and Geriatrics, Leiden University Medical Centre, Leiden, The Netherlands – sequence: 3 givenname: Sirwan K L surname: Darweesh fullname: Darweesh, Sirwan K L organization: Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Neurology, Erasmus Medical Centre, Rotterdam, The Netherlands – sequence: 4 givenname: Daniel surname: Bos fullname: Bos, Daniel organization: Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Radiology and Nuclear Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands – sequence: 5 givenname: Mohammad Arfan surname: Ikram fullname: Ikram, Mohammad Arfan organization: Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Neurology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Radiology and Nuclear Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands – sequence: 6 givenname: Behnam surname: Sabayan fullname: Sabayan, Behnam organization: Department of Gerontology and Geriatrics, Leiden University Medical Centre, Leiden, The Netherlands; Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA – sequence: 7 givenname: Albert surname: Hofman fullname: Hofman, Albert email: ahofman@hsph.harvard.edu organization: Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands. Electronic address: ahofman@hsph.harvard.edu – sequence: 8 givenname: Sanaz surname: Sedaghat fullname: Sedaghat, Sanaz organization: Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
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