SWEDEN: Research Shows Heart Failure, Dementia, Alzheimer Disease Links In the Elderly

STOCKHOLM. Sweden, May 8, 2006: Results of a 9-year long study by Dr. Chengxuan Qiu, of the Karolinska Institute, Stockholm and colleagues, suggest that there is an association between heart failure and an increased risk of dementia or Alzheimer's disease in the elderly. Earlier heart failure has been linked with mental impairment, "but to our knowledge, no investigations have explored the relationship between heart failure and the risk of dementia," states the paper published in today's edition of the Archives of Internal Medicine. The researchers say "heart failure has been linked to cognitive impairment in several previous studies, but to our knowledge, no investigations have explored the relationship between heart failure and the risk of dementia. We sought to examine the hypothesis that heart failure is a risk factor for dementia and Alzheimer disease." A community-based cohort of 1301 individuals 75 years or older and without dementia in Stockholm, Sweden, was examined 3 times over a 9-year period to detect patients with dementia and Alzheimer disease using the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition. Heart failure was defined according to the guidelines of the Task Force on Heart Failure of the European Society of Cardiology by integrating clinical symptoms and signs with inpatient register entries and use of cardiac medications. Data were analyzed using Cox proportional hazards models with adjustment for major potential confounders. During the 6534 person-years of follow-up (mean, 5.02 years per person), 440 subjects were diagnosed as having dementia, including 333 with Alzheimer disease. At baseline, heart failure was identified in 205 subjects. Heart failure was associated with a multi-adjusted hazard ratio (HR) of 1.84 (95% confidence interval [CI], 1.35-2.51) for dementia and 1.80 (95% CI, 1.25-2.61) for Alzheimer disease. Use of antihypertensive drugs (83% of which are diuretics) seemed to reduce dementia risk due to heart failure (HR, 1.38; 95% CI, 0.99-1.94). Heart failure and low diastolic pressure (<70 mm Hg) had an additive effect on the risk for dementia (HR, 3.07; 95% CI, 1.67-5.61). The conclusions of the research is that heart failure is associated with an increased risk of dementia and Alzheimer disease in older adults. Antihypertensive drug therapy may partially counteract the risk effect of heart failure on dementia disorders. Researchers: Chengxuan Qiu, MD, PhD; Bengt Winblad, MD, PhD; Alessandra Marengoni, MD; Inga Klarin, MD; Johan Fastbom, MD, PhD; Laura Fratiglioni, MD, PhD Archives of Internal Medicine. 2006;166:1003-1008. Vol. 166 No. 9, May 8, 2006 © 2006 American Medical Association. All Rights Reserved.