January 26, 2023
Heart Disease When Young Could Bring Memory Issues by Middle Age
THURSDAY, Jan. 26, 2023 -- People who suffer a heart attack or stroke in middle age may develop memory and thinking problems earlier in life, too, a new study finds.
The study, published online Jan. 25 in the journal Neurology, focused on people who had developed premature cardiovascular disease. That refers to heart disease, stroke or leg artery disease that strikes before the age of 60.
The researchers found that those individuals generally performed worse on tests of memory and thinking compared to people their age who were free of cardiovascular conditions. And the differences were already apparent in middle age.
It's not clear what that could ultimately mean for their brain health down the road, said lead researcher Dr. Xiaqing Jiang of the University of California, San Francisco.
But, she said, the findings underscore the fact that everyone, including young adults, should strive for a heart-healthy lifestyle.
It has long been known that there's a connection between heart health and brain health. Most studies, though, have focused on older adults, often linking heart disease and stroke to heightened risks of cognitive impairment (milder problems with memory and other mental skills) and full-blown dementia.
There are multiple reasons that cardiovascular disease could feed those impairments, including reduced blood flow to the brain, Jiang said.
But less has been known about whether premature cardiovascular disease can dull people's mental acuity, and when any such issues become apparent.
The new findings are based on more than 3,100 Americans whose health was tracked for up to 30 years, starting in young adulthood. During that time, 5% developed premature cardiovascular disease — mostly heart disease or stroke, at an average age of 48.
Overall, Jiang's team found, those study participants performed worse on a battery of cognitive tests taken when they were in their 50s, compared with their counterparts who were free of cardiovascular disease.
Strokes, which can damage brain tissue, can impair mental abilities. But in this study, that was not the whole story: When Jiang's team excluded participants who had suffered a stroke, early cardiovascular disease (almost always heart disease) was still linked to poorer cognitive scores.
The connection also stood up when the researchers considered other factors that could affect both cardiovascular health and cognitive performance — including education levels, drinking and smoking, and depression.
That is not definitive proof that premature cardiovascular disease caused the lower test scores, Jiang said.
But the group with early cardiovascular disease did show a faster rate of decline between two test series taken five years apart: 13% showed "accelerated cognitive decline," versus 5% of the comparison group.
"Those folks may be at increased risk of mild cognitive impairment and dementia later in life," said Dr. Ronald Petersen, a professor of neurology at the Mayo Clinic in Rochester, Minn.
Petersen, who is also a fellow with the American Academy of Neurology, was not involved in the study. Like Jiang, he said it "emphasizes the importance of paying attention to cardiovascular health early in life."
Many factors affect cognitive health and dementia risk as people age, Petersen noted. But, in general, it's thought that the same habits that are good for the heart are good for the brain.
That includes maintaining healthy blood pressure, blood sugar and cholesterol levels; not smoking; getting regular exercise; and following a diet such as the traditional Mediterranean one — high in fish, vegetables and "good" fats like olive oil.
For younger people who have already developed cardiovascular disease, Petersen stressed that "this doesn't mean you're doomed."
If anything, he said, the connection between heart and brain health can provide "extra motivation" to make lifestyle changes.
The American Academy of Neurology has more on brain health.
SOURCES: Xiaqing Jiang, MD, PhD, MPH, postdoctoral scholar, psychiatry, University of California, San Francisco; Ronald Petersen, MD, PhD, professor, neurology, and director, Alzheimer's Disease Research Center, Mayo Clinic, Rochester, Minn.; Neurology, Jan. 25, 2023, online