Dataset Information

Associations between coronary heart disease and risk of cognitive impairment: A meta-analysis.

ABSTRACT:

Background

Several studies have demonstrated that coronary heart disease (CHD) is a high risk factor for cognitive impairment, whereas other studies showed that there was no association between cognitive impairment and CHD. The relationship between CHD and cognitive impairment is still unclear based on these conflicting results. Thus, it is of importance to evaluate the association between CHD and cognitive impairment. The present study made a meta-analysis to explore the association between CHD and risk of cognitive impairment.

Methods

Articles exploring the association between CHD and cognitive impairment and published before November 2020 were searched in the following databases: PubMed, Web of Science, Medline, EMBASE, and Google Scholar. We used STATA 12.0 software to compute the relative risks (RRs), odds ratios (ORs), or hazard ratios (HRs) and 95% confidence intervals (CIs).

Results

The meta-analysis showed a positive association between CHD and risk of all-cause cognitive impairment with a random effects model (RR = 1.27, 95% CI 1.18 to 1.36, I² = 82.8%, p < .001). Additionally, the study showed a positive association between myocardial infraction (MI) and risk of all-cause cognitive impairment with a random effects model (RR = 1.49, 95% CI 1.20 to 1.84, I² = 76.0%, p < .001). However, no significant association was detected between angina pectoris (AP) and risk of all-cause cognitive impairment with a random effects model (RR = 1.23, 95% CI 0.95 to 1.58, I² = 79.1%, p < .001). Subgroup studies also showed that CHD patients are at higher risk for vascular dementia (VD), but not Alzheimer's disease (AD) (VD: RR = 1.34, 95% CI: 1.28-1.39; AD: RR = 0.99, 95% CI: 0.92-1.07).

Conclusion

In a word, CHD was significantly associated with an increased risk of developing cognitive impairment.

SUBMITTER: Liang X

PROVIDER: S-EPMC8119850 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Aims/hypothesisAccumulating evidence suggests an association between coronary heart disease and risk for cognitive impairment or dementia, but no study has systematically reviewed this association. Therefore, we summarized the available evidence on the association between coronary heart disease and risk for cognitive impairment or dementia.MethodsMedline, Embase, PsycINFO, and CINAHL were searched for all publications until 8th January 2016. Articles were included if they fulfilled the inclusion criteria: (1) myocardial infarction, angina pectoris or coronary heart disease (combination of both) as predictor variable; (2) cognition, cognitive impairment or dementia as outcome; (3) population-based study; (4) prospective (≥1 year follow-up), cross-sectional or case-control study design; (5) ≥100 participants; and (6) aged ≥45 years. Reference lists of publications and secondary literature were hand-searched for possible missing articles. Two reviewers independently screened all abstracts and extracted information from potential relevant full-text articles using a standardized data collection form. Study quality was assessed with the Newcastle-Ottawa Scale. We pooled estimates from the most fully adjusted model using random-effects meta-analysis.ResultsWe identified 6,132 abstracts, of which 24 studies were included. A meta-analysis of 10 prospective cohort studies showed that coronary heart disease was associated with increased risk of cognitive impairment or dementia (OR = 1.45, 95%CI = 1.21-1.74, p<0.001). Between-study heterogeneity was low (I2 = 25.7%, 95%CI = 0-64, p = 0.207). Similar significant associations were found in separate meta-analyses of prospective cohort studies for the individual predictors (myocardial infarction, angina pectoris). In contrast, meta-analyses of cross-sectional and case-control studies were inconclusive.Conclusion/interpretationThis meta-analysis suggests that coronary heart disease is prospectively associated with increased odds of developing cognitive impairment or dementia. Given the projected worldwide increase in the number of people affected by coronary heart disease and dementia, insight into causal mechanisms or common pathways underlying the heart-brain connection is needed.