New Study Reveals Connection Between Heart Failure and Cognitive Decline: Impact on Thinking and Memory
Recent studies indicate a profound connection between heart failure and cognitive decline. As blood flow to the brain diminishes and inflammation increases, individuals may face challenges in mental processes such as memory and attention. Experts emphasize the importance of taking proactive measures to safeguard brain health for those diagnosed with heart failure.
Cognitive decline is often observed as a side effect of heart failure, as detailed in new research published in Circulation: Heart Failure. The researchers unearthed a significant relationship between a heart failure diagnosis and difficulties in various cognitive functions, including memory and planning.
“Knowing this will help caregivers and patients prepare better and get involved earlier if the patient is struggling,” noted Supriya Shore, MBBS, a clinical assistant professor of cardiology at the University of Michigan and leader of the study. Below is an in-depth look at the study’s findings and the intricate link between heart and brain health.
Understanding Heart Failure
Heart failure occurs when the heart struggles to pump adequate blood and oxygen to other organs. Approximately 7 million people in the United States are affected by this condition. Common causes of heart failure include:
- High blood pressure
- Coronary artery disease: A condition characterized by cholesterol buildup that narrows the arteries and restricts blood flow to the heart.
Despite its name, heart failure doesn’t imply an abrupt stop; rather, symptoms such as shortness of breath, weight gain, and fatigue may develop gradually.
The Connection Between Brain Health and Heart Failure
Shore’s interest in exploring the relationship between brain health and cognitive issues stemmed from discussions with caregivers of heart failure patients, who consistently reported observing cognitive decline in their loved ones. Upon examining existing research, Shore found minimal information regarding the nexus between cognitive decline and heart failure.
To investigate further, Shore and her team analyzed data from six U.S. studies, encompassing nearly 30,000 individuals whose cognitive capabilities were observed between 1971 and 2019. Initially, none of the participants were diagnosed with heart failure, stroke, or dementia. Notably:
- Over half of the participants were women.
- 70% of them were white.
After a follow-up, researchers found that 1,407 participants received a heart failure diagnosis. The implications of this diagnosis included a decline in several areas of cognition at the time of diagnosis:
- Global cognition: This encompasses various mental functions like thinking, attention, language, and learning.
- Executive function: This entails higher-level cognitive skills, including planning, problem-solving, and adaptability.
- Memory: A crucial aspect that reflects cognitive health.
Hannah Rosenblum, MD, an assistant professor of medicine and cardiologist at Columbia University, commented on the phenomenon, stating, “Your whole immune system is ramped up; there are all these cytokines that are leaked into your bloodstream, and that can affect your cognitive function.” The breakdown of the blood-brain barrier during these events further influences cognitive stability.
Interestingly, while memory decline wasn’t significantly pronounced as time passed, both global cognition and executive function exhibited steady declines over time.
Why Heart Failure May Cause Long-Term Cognitive Issues
Research suggests that heart disease, including stroke and coronary artery disease, impacts cognition in several ways. Although there’s no definitive explanation for why heart failure often leads to cognitive decline, the following factors could be involved:
- Heart Changes: Heart failure weakens the heart muscle, impairing blood and oxygen flow to the brain, as explained by Johanna Contreras, MD, director of heart failure at Mount Sinai Hospital.
- Associated Conditions: Cognitive decline can be exacerbated by other conditions related to heart failure, such as diabetes, which affects cognitive health. Research shows that about 40% of individuals with heart failure experience diabetes-related cognitive decline.
- High Blood Pressure: This common heart failure contributor can lead to small points of ischemia in the brain, minimizing blood flow.
- Progression of Heart Failure: As heart failure progresses, it becomes increasingly pro-inflammatory, affecting cognitive function further. As limitations arise, a cycle emerges that leaves the individual less active and consequently impairs cognition.
Conclusion: Implications for Those with Heart Failure
Encountering difficulties in planning and thinking can complicate the self-care required for managing heart failure. Shore emphasizes that “everything about managing heart failure is so patient-centered,” pointing out the necessity for daily weight monitoring and managing multiple medications.
She hopes the findings from this research will not only prepare patients for proactive action but also empower caregivers to recognize the shared burden that heart failure places on both parties. “Heart failure affects two people,” Shore remarked, highlighting the additional challenges faced by caregivers as the disease progresses.
