Summary: According to researchers, people with congenital heart defects have an increased risk of developing dementia later in life. Researchers report those born with congenital heart disease are 2.6 times more likely to develop dementia symptoms by the age of 65.
Source: American Heart Association.
Being born with a heart defect may raise the odds of later developing dementia, especially early-onset dementia, a new study finds.
Each year, at least 40,000 infants in the United States are affected by a congenital heart defect. The cause is unknown, but it’s thought that genetics plays a role in some cases.
Throughout their lives, children born with a heart defect are at risk of experiencing an array of health issues. These range from being below normal weight to heart-specific problems that not only make exercise difficult but, in severe cases, can increase their risk of having heart failure or a serious infection of the inner lining of the heart chambers and valves.
Many of these health problems are known risk factors for dementia — changes in the brain that cause memory and other cognitive problems that interfere with daily life.
“Congenital heart disease is a lifelong condition,” said the study’s senior author Dr. Nicolas L. Madsen, medical director of inpatient cardiology at Cincinnati Children’s Hospital. “We think that dementia may be a natural extension of the neurodevelopmental concerns of childhood into the adult years.”
In the study, published Monday in Circulation, researchers used Denmark’s national medical registries to identify 10,632 adults diagnosed with a congenital heart defect. They compared dementia diagnoses between those adults and adults of the same sex and age in the general population.
By age 80, 4 percent of adults with congenital heart disease had been diagnosed with dementia. This was a 60 percent higher risk than what was seen in the general population. Those born with a heart defect were also 2.6 times more likely to develop dementia before age 65.
An estimated 1 million children and 1.4 million adults in the United States were born with a congenital heart defect.
“We’re only now seeing CHD patients reach older adulthood,” said cardiologist Dr. Fred Wu, who is seeing more noncardiac diseases, such as diabetes, high blood pressure and obesity, among his patients in the Adult Congenital Heart Service at Boston Children’s Hospital. Wu was not involved in the new study.
“This [study] opens our eyes to the problem we know very little about: how to prevent dementia and cognitive deficits,” said Wu, who co-authored the American Heart Association’s 2017 scientific statement on complications in adults with congenital heart disease. “Questions, however, remain as to what is the underlying cause of the risk and how can we mitigate it.”
Roughly 50 million people worldwide have dementia. In the United States, Alzheimer’s disease is the most common form of dementia in older adults, affecting 5.5 million Americans and ranking as the nation’s No. 6 cause of death.
It is not known whether the new findings are applicable to children born today with a heart defect who benefit from improved medical care.
“The care received by the group we studied at 60, 70 and 80 years old isn’t the same today, so we don’t know if the congenital heart defect population today would show the same risk,” said Madsen.
Source: American Heart Association
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Image Source: NeuroscienceNews.com image is credited to AHA.
Original Research: Abstract in Circulation.
Risk of Dementia in Adults With Congenital Heart Disease: Population-Based Cohort Study
Background — More children with congenital heart disease (CHD) are surviving to adulthood, and CHD is associated with risk factors for dementia. We compared the risk of dementia in CHD adults to that of the general population.
Methods — In this cohort study, we used medical registries and a medical record review covering all Danish hospitals to identify adults with CHD diagnosed between 1963 and 2012. These individuals with CHD were followed from January 1, 1981, 30 years of age, or date of first CHD registration (index date for matched members of the general population cohort) until hospital diagnosis of dementia, death, emigration, or end of study (December 31, 2012). For each individual with CHD, we identified 10 members of the general population utilizing the Danish Civil Registration System matched on sex and birth year. We computed cumulative incidences and hazard ratios (HRs) of dementia, adjusting for sex and birth year.
Results — The cumulative incidence of dementia was 4% by 80 years of age in 10 632 adults with CHD (46% male). The overall HR comparing adults with CHD with the general population cohort was 1.6 (95% confidence interval [CI], 1.3−2.0). The HR among individuals with CHD without extracardiac defects was 1.4 (95% CI, 1.1−1.8). Adults with mild-to-moderate CHD had an HR of 1.5 (95% CI, 1.1−2.0), whereas the HR was 2.0 (95% CI, 1.2−3.3) for severe CHD, including univentricular hearts. The HR for early onset dementia (<65 years of age) was 2.6 (95% CI, 1.8−3.8), whereas the late-onset HR was 1.3 (95% CI, 1.0−1.8).
Conclusions — CHD was associated with an increased risk of dementia compared with the general population, in particular for early onset dementia. Further understanding of dementia risk in the population with CHD is a potential target for future investigation.