Written By Lisa S. Jones / Reviewed By Ray Spotts
Research published recently in the Journal of the American College of Cardiology says that people with a higher risk of developing cardiovascular disease have increased cognitive decline. This includes an increase in typical markers of Alzheimer's disease and suggests that monitoring and controlling for heart disease may be key to maintaining and improving cognitive health later in life.
The researchers’ goal was to compare Framingham General Cardiovascular Risk Scores (FGCRS), which incorporate demographic information with traditional cardiovascular risk factors to assess future risk, to an individual's long-term decline in global and domain specific cognitive function.
For the study, 1,588 dementia-free participants with an average age was 79.5 from the Rush Memory and Aging Project were followed for 21 years. Their FGCRS was assessed at baseline and categorized into lowest, middle and highest groups according to heart disease risk.
Higher Cardiovascular Risk And Faster Memory Decline
Researchers found that having a higher cardiovascular risk burden was associated with faster decline in episodic memory, working memory and perceptual speed. Higher FGCRS was associated with smaller volumes of hippocampus, cortical gray matter and total brain. Decreases in hippocampal and gray matter are typical markers of Alzheimer's dementia-related neurodegeneration.
MRIs also showed a greater volume of white matter hyperintensities, which are white spots on the brain that cause an area to decline in functionality. Episodic memory and working memory were related to hippocampal volume, but perceptual speed was associated with white matter hyperintensities, showing that results from the memory tests and the MRI were complementary.
"In the absence of effective treatments for dementia, we need to monitor and control cardiovascular risk burden as a way to maintain patient's cognitive health as they age," says Weili Xu, Ph.D., Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China. "Given the progressive increase in the number of dementia cases worldwide, our findings have both clinical and public health relevance."
The Link Between Good Heart Health And Lower Dementia Risk
Another recent study claims that good cardiovascular health at age 50 is associated with a lower risk of dementia later in life. The findings – published in The BMJ - support public health policies to improve cardiovascular health in middle age to promote later brain health.
The findings are based on cardiovascular data collected from 7,899 British men and women at age 50 in the Whitehall II Study, which is looking at the impact of social, behavioral, and biological factors on long-term health.
Designed for "primordial" prevention, where the aim is to prevent the development of risk factors themselves in order to affect risk of disease, this study is the sum of four behavioral metrics - smoking, diet, physical activity, body mass index - and three biological metrics - fasting glucose, blood cholesterol, blood pressure - categorized into poor (scores 0-6), intermediate (7-11), and optimal (12-14) cardiovascular health.
The evidence, however, remains inconsistent so to address this uncertainty, an international research project led by Séverine Sabia from the French National Institute of Health and Medical Research and University College London, examined the association between the Life Simple 7 cardiovascular health score at age 50 and risk of dementia over the next 25 years.
Participants were free of cardiovascular disease and dementia at age 50. Dementia cases were identified using hospital, mental health services, and death registers until 2017. Of the 7,899 participants, 347 cases of dementia were recorded over an average follow-up period of 25 years. Average age at dementia diagnosis was 75 years.
Life’s Simple 7 For Good Heart Health
Dementia is a progressive disease that can start to develop 15 to 20 years before any symptoms appear, so identifying factors that might prevent its onset is important. The American Heart Association's "Life Simple 7" cardiovascular health score - initially designed for cardiovascular disease - is a potential tool for preventing dementia.
After taking account of potentially influential factors, the researchers found that adherence to the Life Simple 7 cardiovascular health recommendations in midlife was associated with a lower risk of dementia later in life.
Compared with an incidence rate of dementia of 3.2 per 1,000 person years among the group with a poor cardiovascular score, those with an intermediate score had an incidence of 1.8 per 1,000 person years, while those with an optimal score had an incidence of 1.3 per 1,000 person years.
This is an observational study and cannot establish cause. The researchers point to some limitations, for example relying on self-reported measures and potentially missing cases of dementia in patient records. However, a higher cardiovascular health score at age 50 was also associated with higher whole brain and grey matter volumes in MRI scans 20 years later.
Reductions in dementia risk were also evident across the continuum of the cardiovascular score, suggesting that even small improvements in cardiovascular risk factors at age 50 may reduce dementia risk in old age.
"Our findings suggest that the Life's Simple 7, which comprises the cardiovascular health score, at age 50 may shape the risk of dementia in a synergistic manner," the researchers stated. "Cardiovascular risk factors are modifiable, making them strategically important prevention targets. This study supports public health policies to improve cardiovascular health as early as age 50 to promote cognitive health."
Psychology And Heart Health
Do you know that positive thoughts can be the key to managing heart disease? According to a recent review paper - also published in the Journal of the American College of Cardiology - when patients with heart disease maintain positive thoughts during intervention programs the program has a more successful outcome.
The authors of the review researched various studies to see the relationship between psychological well-being and a reduced risk of having heart disease. A 2017 study showed that older women who were filled with optimism had about a 38 percent reduced risk of heart disease.
Researchers showed that patients with a high level of optimism will always want to eat healthy foods such as fruits and vegetables and engage in various physical activities which help them maintain a healthy weight. They also limit their consumption to refined foods and sugar. After a year of observation, they didn’t engage in unhealthy habits such as smoking.
The optimist patient will look for how to manage stressors by mapping out plans and strategies. This might be different from a pessimist who, according to the lead author of the review, Darwin R. Labarthe, will “begin to shift their goals and use potentially maladaptive coping strategies, which would ultimately result in raising inflammation levels and less favorable overall heart health.”
In the review, the authors stated the processes through which psychological well-being led to an improvement in heart health. The processes include health behaviors, psychosocial resources, and biological processes.
Other Ways Of Improving Heart Health
Aside from optimism, having a strong support group can also help to improve the health of patients with heart diseases. Patients who are lucky to find themselves in a positive social environment will take medical advice seriously and will be open to options that will help improve heart conditions.
Mindfulness programs are one of the ways to improve the psychological well-being of the patients thereby reducing the risk of heart disease. When compared to intervention programs - which also play a positive role - mindfulness programs go a step further to improve both the physical and psychological well-being of the patients.
These programs incorporate tai-chi and yoga which lowers blood pressure and improves symptoms in patients with heart failure. The program recorded success in encouraging healthy diets, reducing anxiety, discouraging unhealthy habits such as smoking and generally improving the quality of life.
There is also the life purpose program which improves the mental health and the general well-being of patients. It is specially meant for palliative care patients and has significantly improved their symptoms.
Not everyone will have an optimistic approach towards an ailment they’ve been recently diagnosed with. It takes some time to adjust to that reality, and it is the role of medical personnel and psychologists to have meaningful discussions with the patients on ways to improve their psychological well-being to better tackle the heart condition. Just having patient-centered discussions surrounding sources of psychological well-being and information about specific activities to promote well-being is a small but meaningful part of a patient’s care.
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Lisa S. Jones is a certified nurse, nutritionist, fitness coach and health expert. Her training credentials include a B.Sc. in Nursing from California State University in 2013 and Youth Nutrition Specialist Certification from the American Fitness Professionals and Associates in 2015. In 2017, she also received Holistic Nutrition Certification from the American Fitness Professionals and Associates.
Founder Ray Spotts has a passion for all things natural and has made a life study of nature as it relates to health and well-being. Ray became a forerunner bringing products to market that are extraordinarily effective and free from potentially harmful chemicals and additives. For this reason Ray formed Trusted Health Products, a company you can trust for clean, effective, and healthy products. Ray is an organic gardener, likes fishing, hiking, and teaching and mentoring people to start new businesses. You can get his book for free, “How To Succeed In Business Based On God’s Word,” at www.rayspotts.com.