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Coronary heart disease and risk for cognitive impairment or dementia: Systematic review and meta-analysis.
PLoS One 2017; 12(9):e0184244Plos

Abstract

AIMS/HYPOTHESIS

Accumulating 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.

METHODS

Medline, 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.

RESULTS

We 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/INTERPRETATION

This 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.

Authors+Show Affiliations

Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.Departamento de Psiquiatria, Hospital Alvaro Cunqueiro, Complexo Universitario de Vigo, Vigo, Spain.Department of Neurology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands.Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

28886155

Citation

Deckers, Kay, et al. "Coronary Heart Disease and Risk for Cognitive Impairment or Dementia: Systematic Review and Meta-analysis." PloS One, vol. 12, no. 9, 2017, pp. e0184244.
Deckers K, Schievink SHJ, Rodriquez MMF, et al. Coronary heart disease and risk for cognitive impairment or dementia: Systematic review and meta-analysis. PLoS ONE. 2017;12(9):e0184244.
Deckers, K., Schievink, S. H. J., Rodriquez, M. M. F., van Oostenbrugge, R. J., van Boxtel, M. P. J., Verhey, F. R. J., & Köhler, S. (2017). Coronary heart disease and risk for cognitive impairment or dementia: Systematic review and meta-analysis. PloS One, 12(9), pp. e0184244. doi:10.1371/journal.pone.0184244.
Deckers K, et al. Coronary Heart Disease and Risk for Cognitive Impairment or Dementia: Systematic Review and Meta-analysis. PLoS ONE. 2017;12(9):e0184244. PubMed PMID: 28886155.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Coronary heart disease and risk for cognitive impairment or dementia: Systematic review and meta-analysis. AU - Deckers,Kay, AU - Schievink,Syenna H J, AU - Rodriquez,Maria M F, AU - van Oostenbrugge,Robert J, AU - van Boxtel,Martin P J, AU - Verhey,Frans R J, AU - Köhler,Sebastian, Y1 - 2017/09/08/ PY - 2017/02/14/received PY - 2017/08/21/accepted PY - 2017/9/9/entrez PY - 2017/9/9/pubmed PY - 2017/10/19/medline SP - e0184244 EP - e0184244 JF - PloS one JO - PLoS ONE VL - 12 IS - 9 N2 - AIMS/HYPOTHESIS: Accumulating 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. METHODS: Medline, 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. RESULTS: We 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/INTERPRETATION: This 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. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/28886155/Coronary_heart_disease_and_risk_for_cognitive_impairment_or_dementia:_Systematic_review_and_meta_analysis_ L2 - http://dx.plos.org/10.1371/journal.pone.0184244 DB - PRIME DP - Unbound Medicine ER -