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Cognitive decline accelerates after heart attack, study finds

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A heart attack may put people at risk for accelerated cognitive decline later in life, beyond levels considered appropriate for an aging mind, according to new research.

Everyone’s brain ages as the years go by, but some people age more than others. What is considered normal is usually very subtle. It slows processing, reduces your ability to pay attention, and often struggles to find the right words. but, Cognitive decline with aging Experts argue that it is quite different from Alzheimer’s disease and other dementias and should not be confused with them.

In new research, Published on Tuesday In the journal JAMA Neurology, researchers analyzed data from six major studies of heart disease and cognition conducted in the United States between 1971 and 2019. None of the 30,465 people selected for these studies had dementia or had a heart attack or stroke prior to study initiation, and all had undergone at least one cognitive assessment. .

However, over the course of the study, more than 1,000 of the participants had an acute myocardial infarction or heart attack. Although there were no immediate changes in cognition, the cognitive scores of heart attack survivors accelerated at a much more rapid rate over the next six years or so than their non-heart attack peers. Did.

There was a modest increase in the annual rate of decline in people who had heart attacks, Dr. Eric Smith and Dr. Lisa Silbert write in an accompanying editorial: Mr. Smith is the Medical Director of the Cognitive Neuroscience Clinic at the University of Calgary, Alberta, and Mr. Silbert is Professor of Neurology at the Oregon Health and Science University School of Medicine in Portland.

However, “advanced subclinical debilitation over years or decades may eventually lead to impaired function and decreased cognitive reserve, resulting in age-related neurodegeneration.” It can make you more susceptible to medical conditions,” Smith and Silbert wrote.

The steepest annual decline after heart attack was seen in whites compared with blacks and in men compared with women, but the study found that it could not be explained by stroke or new atrial fibrillation. to heart thrombosis.

Smith and Silbert noted that this is not the first study to find a link between accelerated cognitive decline and heart attacks.

“The accelerated annual rate of cognitive decline after MI (myocardial infarction) was also seen in 7888 participants of the UK Longitudinal Study on Aging, of whom 254 had MI and 286 had MI during up to 12 years of follow-up. suffered from angina,” they wrote.

Similar to the new study, people who had a heart attack or angina pectoris (chest pain) had annual rates of cognitive decline similar to those who had never had a heart attack before the attack, but accelerated afterwards. The researchers added that they experienced cognitive decline.

But the exact mechanisms that can cause cognitive decline are still unclear, Smith and Silbert noted.

“Stroke was ruled out as the cause of the decline,” the researchers wrote, adding that damage to heart tissue after stroke was unlikely.

“The lack of immediate cognitive decline, followed by a sharp decline over the next few years, suggests that heart attacks are associated with a slow, progressive process that accelerates cognitive decline. There are,” the researchers wrote.

A possible explanation, the researchers said, could include post-heart attack depression, which has been linked to dementia. Chronic inflammation, blood pressure abnormalities, and small-vessel disease, which are also associated with dementia, may also play a role, researchers said.

“Although the mechanism of cognitive decline after myocardial infarction is unknown, the risk appears to be real,” Smith and Silbert wrote. “Patients with a history of myocardial infarction should be queried regularly about their cognitive symptoms and undergo follow-up cognitive screening…In some cases, referral to a cognitive specialist or neuropsychologist may be warranted. ”

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