14 December 2013 American Heart Association
Heart disease may put older postmenopausal women at higher risk for decreased brain function such as dementia, according to new research in Journal of the American Heart Association.
“Our study provides further new evidence that this relationship (between heart disease and dementia) does exist, especially among postmenopausal women,” said study author Bernhard Haring, M.D., M.P.H., clinical fellow in the Comprehensive Heart Failure Center and the Department of Internal Medicine I at the University of Würzburg in Germany. “And many different types of heart disease or vascular disease are associated with declining brain function.”
Researchers, conducting neurocognitive exams on nearly 6,500 U.S. women ages 65-79 who had healthy brain function at the start of the study, found:
- Postmenopausal women with heart disease or vascular disease were 29 percent more likely to experience cognitive decline over time compared with women without heart disease.
- The risk for cognitive decline was approximately double among women who had a heart attack compared with those who had not had a heart attack.
- Women who had heart bypass surgery, carotid endarterectomy (surgical removal of a blockage in a neck artery) or peripheral artery disease were at greater risk for cognitive decline.
- Risk factors such as high blood pressure and diabetes increased risk for cognitive decline over time.
- Obesity didn’t notably increase cognitive decline in elderly women.
“Women with heart disease — in particular women who have had a heart attack, bypass surgery, heart failure, atrial fibrillation, peripheral vascular disease or carotid endarterectomy — should be monitored by their doctors for potential cognitive decline,” Haring said. “It is also very important to adequately manage heart disease risk factors such as high blood pressure and diabetes.”
Dementia is an increasingly significant problem in developed countries, so researchers said more study is warranted on how preventing cardiovascular disease may preserve cognitive health.
Co-authors are Xiaoyan Leng, M.D., Ph.D.; Jennifer Robinson, M.D.; Karen C. Johnson, M.D., M.P.H.; Rebecca D. Jackson, M.D.; Rebecca Beyth, M.D., M.Sc.; Jean Wactawski-Wende, Ph.D.; Moritz Wyler von Ballmoos, M.D., M.P.H., Ph.D.; Joseph S. Goveas, M.D.; Lewis H. Kuller, M.D., Dr.PH.; and Sylvia Wassertheil-Smoller, Ph.D. Author disclosures are on the manuscript.
The National Institutes of Health funded the study.
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Full bibliographic informationHeart disease linked with dementia in older postmenopausal women
Bernhard Haring, M.D., M.P.H.
Cardiovascular Disease and Cognitive Decline in Postmenopausal
Women: Results From the Women’s Health Initiative Memory Study
J Am Heart Assoc. 2013;2:e000369 doi: 10.1161/JAHA.113.000369
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There are many different causes of dementia and, although its progression can be fast or slow, it is always degenerative. Symptoms of dementia include confusion, loss of memory, and problems with speech and understanding. It can be upsetting for both the affected person and their relatives and carers. New research published in BioMed Central’s open access journal BMC Medicine shows that a regime of behavioral and mental exercises was able to halt the progression of dementia.
Researchers led by Prof. Graessel, from Friedrich-Alexander-University Erlangen, included in their study patients with dementia from five nursing homes in Bavaria. After random selection, half the patients were included on the year-long MAKS ‘intervention’ consisting of two hours of group therapy, six days a week. In addition all patients maintained their normal treatment and regular activities provided by the nursing home.
The MAKS system consists of motor stimulation(M), including games such as bowling, croquet, and balancing exercises; cognitive stimulation (K), in the form of individual and group puzzles; and practicing ‘daily living’ activities (A), including preparing snacks, gardening and crafts. The therapy session began with a ten minute introduction, which the researchers termed a ‘spiritual element’ (S), where the participants discussed topics like ‘happiness’, or sang a song or hymn.
After 12 months of therapy the MAKS group maintained their level on the Alzheimer’s Disease Assessment Scale (ADAS) and, even more importantly maintained their ability to carry out activities of daily living, while the control group all showed a decrease in cognitive and functional ability.
Prof. Graessel explained, “While we observed a better result for patients with mild to moderate dementia, the result of MAKS therapy on ADAS (cognitive function) was at least as good as treatment with cholinesterase inhibitors. Additionally we found that the effect on the patients’ ability to perform daily living tasks (as measured by the Erlanger Test of Daily Living (E-ADL)) was twice as high as achieved by medication. This means that MAKS therapy is able to extend the quality of, and participation in, life for people with dementia within a nursing home environment. We are currently in the process of extending these preliminary results to see if this prevention of dementia decline can be maintained over a longer time period.”
Full bibliographic information Non-pharmacological, multicomponent group therapy in patients with degenerative dementia: a 12-month randomised, controlled trial, Elmar Graessel, Renate Stemmer, Birgit Eichenseer, Sabine Pickel, Carolin Donath, Johannes Kornhuber and Katharina Luttenberger, BMC Medicine (in press).