Is There A Connection Between Heart Failure And Cognitive Impairment
Causes of memory loss and cognitive impairment have also been clearly associated with congestive heart failure. One study identified patients with heart failure who had anemia as having a greater than four times more risk of cognitive impairment compared to the heart failure patients who did not have anemia.
Can Brain Fog Be Improved By Lifestyle Strategies
To evaluate whether there is an effective treatment strategy, the researchers initiated a pilot study of 69 individuals, ages 51-71 years old, looking at the effects of a walking program combined with a brain training intervention on cognitive function in people receiving care for heart failure.2
The testing group comprised 54% women and 55% African American individuals.2 The subjects, all of whom had been diagnosed with heart failure and who had confirmed brain fog, were divided into three groups:
- BrainHQ training plus walking
Search Strategy And Selection Criteria
In the present study, we searched for articles published until August 2019 in the following databases: PubMed, Web of Science, EMBASE, Medline and Google Scholar. Search terms were showed as follows: AND . After exclusion of duplicates, 2179 studies were included. All included studies should report relative risk or odds ratio and 95% confidence intervals related to heart failure and risks of dementia. Those studies were also included if the RR or OR and 95%CI could be calculated from the data provided in the studies. In addition, we eliminated secondary processing articles and case-reports from the present study.
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What Causes Brain Fog In People With Heart Failure
The vast majority of heart failure patients have comorbidities like type 2 diabetes or chronic obstructive pulmonary disease , Dr. Costanzo says. Some of these other common conditions that commonly arise in patients with heart failure may also contribute to the cognitive impairments experienced by some heart failure patients.
Data Sources And Searches
The following ten databases were searched on 22 March 2016: MEDLINE, CINAHL, EMBASE, EBSCOHost, PsychINFO, ProQuest Research Library, Health Technology Assessment Database, The Cochrane Library, Web of Science and Scopus.
Key terms describing dementia, an aged population, HF and self-management were identified by JEI and JL , adapted to each database and used to conduct a systematic search. A bibliographic review of included articles was conducted identify additional relevant studies.
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Heart Failure Patients Have Similar Odds Of Dementia
Paris, France 2 Sept 2019: A type of brain damage linked with dementia and cognitive impairment is as common in heart failure patients as it is in patients with a history of stroke, according to findings from the LIFE-Adult-Study presented today at ESC Congress 2019 together with the World Congress of Cardiology.
The probability of this damage, called white matter lesions , was also linked to the duration of heart failure. Patients with a long-standing diagnosis had more WML compared to those more recently diagnosed.
Up to 50% of older patients with heart failure have cognitive impairment and heart failure is associated with an increased risk for dementia, said study author Dr Tina Stegmann of Leipzig University Hospital, Germany. However, it is still unclear what the pathological pathways are. Some investigators have identified changes in brain structure in patients with heart failure and cognitive dysfunction, but the findings are inconsistent.
LIFE-Adult is a population-based cohort study conducted in Leipzig. Between 2011 and 2014, 10,000 residents aged 18 to 80 were randomly selected for inclusion in the study. Participants underwent assessments such as a physical examination and medical history during which information on health conditions for example heart failure and stroke was collected.
Cognitive Impairment In Heart Failure
1Department of Neurology, University of Thessaly, University Hospital of Larissa, P.O. Box 1400, Larissa, Greece
2Department of Cardiology, University of Thessaly, University Hospital of Larissa, Larissa, Greece
3TEI of Lamia, Lamia, Greece
Heart failure is a major and growing health problem in the developed world that affects 1-2% of the adult population and 610% of people over the age of 65 . HF is associated with frequent hospital admissions, reduced quality of life, significant morbidity, and increased mortality . It is estimated that elderly HF patients have high readmission rates ranging from 40 to 50% within 6 months . Significant predictors of HF decompensation and high readmission rates include patients poor compliance with therapy and diet restrictions, and their failure to recognize early symptoms of HF deterioration which may be the consequences of cognitive impairment and poor insight .
In this paper, we outline the spectrum of cognitive functional domains and describe the specific patterns of cognitive decline and their consequences in patients with HF. We also discuss the current understanding of the underlying mechanisms that affect neuronal function in HF and finally we provide suggestions for future research in this field.
2. Cognition and Cognitive Impairment
3. Pathophysiology of CI in HF
4. Impairment of Cognitive Domains in Heart Failure
4.2. Attention-Working Memory-Psychomotor Speed
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Bhf Research Into Vascular Dementia And Stroke
Professor Joanna Wardlaw and her team at the University of Edinburgh are trying to predict whos at risk of developing vascular dementia after suffering a stroke. The team are collecting information from hospital records, and performing thinking and memory tests on 2,000 people who have suffered a stroke. Theyre also collecting blood samples and carrying out brain scans to look for measurements that could act as markers for vascular dementia.This work could help doctors better detect cognitive problems and help them decide on the best care for each individual patient.
What Is Vascular Dementia
Vascular dementia is the second most common form of dementia after Alzheimer’s disease. It’s caused when decreased blood flow damages brain tissue. Blood flow to brain tissue may be reduced by a partial blockage or completely blocked by a blood clot.
Symptoms of vascular dementia may develop gradually, or may become apparent after a stroke or major surgery, such as heart bypass surgery or abdominal surgery.
Dementia and other related diseases and conditions are hard to tell apart because they share similar signs and symptoms. Although vascular dementia is caused by problems with blood flow to the brain, this blood flow problem can develop in different ways. Examples of vascular dementia include:
- Mixed dementia. This type occurs when symptoms of both vascular dementia and Alzheimer’s exist.
- Multi-infarct dementia. This occurs after repeated small, often “silent,” blockages affect blood flow to a certain part of the brain. The changes that occur after each blockage may not be apparent, but over time, the combined effect starts to cause symptoms of impairment. Multi-infarct dementia is also called vascular cognitive impairment.
Researchers think that vascular dementia will become more common in the next few decades because:
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Heart Health And Memory Decline
The body is one unit that all works together in fascinating ways. When it comes to your brain and heart, the health of one directly affects the health of the other, and that means poor heart health can lead to memory decline.
Fatty plaque and stiff arteries lower the blood supply to all parts of the body, including the brain. The small blood vessels inside the brain are more easily blocked, which can mean a higher risk of stroke and other issues. When a stroke occurs, large sections of brain tissue die, and many stroke survivors end up dealing with dementia as well.
Theres a clear link between lowered blood flow and a variety of issues related to the brain, including Alzheimers. Beta-amyloid buildup, which is the main indicator of the disease, comes from hypoperfusionor a lack of blood to the brain over the long term. The type of dementia thats tied to blood flow is called vascular dementia. But even without dementia, your heart health can impact your memory.
In one study, heart problems nearly doubled the risk of mild cognitive impairment. That includes coronary heart disease, heart failure, atrial fibrillation, and a whole range of other issues. Women were particularly at risk over men.
Heart failure itself causes a kind of brain fog that lowers cognitive function, especially early on after a heart attack. This can be overcome with training and rehabilitation, but it can affect quality of life for anyone whos had a heart attack.
What Does Lewy Body Dementia Look Like
Lewy body dementia affects a persons ability to think and process information and it can negatively impact memory and alter personality. Though it shares aspects of other forms of dementia, there are distinct hallmarks of LBD. Lewy body dementia symptoms include:
- Fluctuating attention/alertness: These shifts can last hours or go on for days. The person may stare into space, appear lethargic or drowsy, and have hard-to-understand speech, appearing a lot like delirium. At other times, the person may have much more clarity of thought.
- Visual hallucinations: Often, these are very detailed hallucinations and visions of people or animals, and they can recur.
- Movement disorders: Parkinsons-like movement issues, such as muscle rigidity, tremors, falls, or a shuffling gait or way of walking, may occur.
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How Is Vascular Dementia Linked To Atrial Fibrillation And Stroke
Atrial fibrillation is an irregular heart rhythm which increases your risk of stroke.AF can cause a blood clot to form in one of the top chambers of your heart. This can then be pumped out of your heart to your brain where it can cause a stroke.As vascular dementia often develops after a stroke, people with AF are at higher risk.
Heart Attack Survivors At Risk Of Later Dementia
Heart attack survivors have an increased risk for developing dementia, a new study has found.
Danish researchers studied 314,911 heart attack patients and compared them with 1,573,193 controls who had not had a heart attack. They excluded anyone who had already been diagnosed with dementia or other memory disorders. The study, in Circulation, adjusted for heart failure, pulmonary disease, head trauma, kidney disease and many other variables.
During 35 years of follow-up, there were 3,615 cases of Alzheimers disease, 2,034 cases of vascular dementia and 5,627 cases of other dementias among the heart attack patients.
There was no association of heart attack with Alzheimers disease. But heart attack increased the risk for vascular dementia, the type caused by impaired blood flow to the brain, by 35 percent.
There are several possible reasons for the link, including similar underlying causes for dementia and heart attack among them, hypertension, stroke and having undergone coronary artery bypass surgery.
The researchers had no data on smoking, and they acknowledge that there may be other variables they were unable to account for.
Dementia cant be cured, said the lead author, Dr. Jens Sundboll, a resident in cardiology at Aarhus University in Denmark. Whats the solution? Prevention. And for prevention we have to identify risk factors. Here weve identified an important one.
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Risk Factors For Heart Disease And Dementia
But there are other shared risk factors. Some you cant do much about, like family history or certain gene mutations.
But its not all out of your control. There are for both heart disease and dementia that you can take active steps to reverse:
High blood pressure
These risk factors increase the risk of a process called atherosclerosis the buildup of fatty plaque in the key blood vessels that supply the heart, the brain, and many other important organs and tissues. Atherosclerosis is the process underlying many types of heart disease, including heart attacks, high blood pressure, and heart failure, as well as strokes and vascular dementia.
The good news? Treating or reversing risk factors for atherosclerosis and heart disease can lower the risk of getting dementia. In fact, up to one-third of cases of dementia could be prevented by managing these reversible risk factors.
Impact Of Cognitive Impairment And Domains On Self
Nine studies explored the impact of CI on self-care .
Table 3 Study Outcomes, Impact of Cognitive Impairment, Relevant Risk Factors and Suggested Strategies
Relationship between global cognition and self-care
At the commencement of an educational intervention program for HF patients, patients with an MMSE < 24 had lower scores in self-care and HF knowledge when compared to those who had MMSE scores > 24 at baseline. However, there was no difference between the two groups after 6 months . Subjects with MoCA scores < 24 also had worse consulting behavior scores than their counterparts with scores > 24 .
In one study, cognitive function assessed by MMSE score did not significantly predict self-care ability despite contributing to detection of variance in domains of care in the authors model .
In contrast, Dickson and colleagues demonstrated a significant association of CI with improved self-management and maintenance scores. Further, MoCA scores were significant for predicting self-care management abilities with subjects scoring < 26 being less likely to call a doctor or nurse for disease management guidance . Potentially impacting self-care, subjects with a history of major adverse cardiac events had lower K-MMSE scores compared to those who were event free .
A summary of the influence of specific cognitive domains on self-care is presented in Table .
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All Prescription Blood Thinners Are Dangerous
Dont be taken in by the scary headlines. Warfarin is a dangerous drug, its true. But all prescription blood thinners are dangerous. All have a long list of side effects. Not surprisingly the most common of these is bleeding, and it can be serious. Blood thinners can also affect your liver. They can cause kidney problems. They commonly cause gastrointestinal issues. And there are many more possible side effects.
Warfarin, in spite of its dangers, appears to have somewhat fewer of these than the newer drugs. You are more likely to have an episode of bleeding with it than with the new kids on the block. However, bleeding from the new drugs is much, much harder to control. This is one of the reasons that warfarin continues to be popular with doctors.
Are there any natural blood thinners out there? There are, and Ill tell you about them in a moment. But first Id like to say this: if youre on a blood thinner and you want to try a natural alternative, this is one time you really should talk to your doctor. He may not approve. In fact he probably wont. Hell probably do his best to discourage you, so be prepared. But you need to have the conversation so that he knows exactly what youre doing and can adjust whatever medication youre taking accordinglyso that you dont either develop clots or have a serious bout of bleeding.
Garlic has also shown powerful anti-platelet activity. Dosage is 1-2 grams daily, and it can be found in odorless capsule form in any health food store.
What You Can Do For Your Loved One
In addition to symptom management, its important for the family caregiver to learn how to recognize the end-of-life signs for CHF, and when they should contact hospice. Hospice care will be able to address the specific needs of CHF patients in their final days, and help them to get the most out of what time they have left.
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How Is Vascular Dementia Diagnosed
In addition to a complete medical history and physical exam, your healthcare provider may order some of the following:
- Computed tomography . This imaging test uses X-rays and a computer to make horizontal, or axial images of the brain. CT scans are more detailed than general X-rays.
- FDG-PET scan. This is a PET scan of the brain that uses a special tracer to light up regions of the brain.
- Electroencephalogram . This test measures electrical activity in the brain
- Magnetic resonance imaging . This test uses large magnets, radiofrequencies, and a computer to make detailed images of the brain.
- Neuropsychological assessments. These tests can help sort out vascular dementia from other types of dementia and Alzheimer’s.
- Neuropsychiatric evaluation. This may be done to rule out a psychiatric condition that may resemble dementia.
Can Heart Problems Cause Brain Problems
A recent study shows people diagnosed with heart disease may have more brain changes than those with healthy hearts. Researchers studied 7,888 people over the age of 50 for more than a decade. None of the participants had a history of heart attack, chest pain, stroke, or dementia at the start of the study.
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How Alzheimers Disease Can Affect Heart Health
Alzheimers disease is the most prevalent type of dementia, making up 60-80 percent of dementia cases. While it mostly affects people later in life, this condition can occur at any age. The disease is primarily categorized by the gradual loss of memory and other cognitive abilities. For this reason, it is primarily thought of as a condition that affects the mind. However, a new study has revealed that Alzheimers disease does not just affect the brain, it can affect the entire body, including the cardiovascular system.
Cognitive Impairment And Lifestyle Adherence
Patients who either had impairments in multiple separate domains or global cognition had poor self-care maintenance abilities. These were namely medication adherence, compliance with lifestyle recommendations or requiring assistance with ADLs . The impact of cognition on these aspects of self-care is important as it determines the execution of these key activities. For instance, medication management and driving are inextricably linked to outcomes such as re-hospitalisation or admissions to geriatric units respectively .
One proposed theory for impaired self-care ability is that as cognitive decline diminishes so does functional ability with the resulting lessened influence of personal values towards self-care . Specifically, cognitive domains implicated included attention/information processing, executive function, language and finally, visuospatial and constructional abilities. Attentional control and executive functioning are domains often impaired in most chronic, systemic diseases .
If attention and poor concentration are an issue it may distract from execution of certain tasks while impairment in prospective memory may have an adverse impact on engagement in self-care behaviours such as picking up prescriptions from the pharmacist, attending clinical appointments, treatment adherence and daily weighing, all of which are important in HF self-management .
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