People with congenital heart disease who survived to adulthood had an elevated risk for dementia, particularly early-onset dementia, compared with the general population, according to a study published in Circulation.
“Previous studies showed that people born with heart defects have a higher risk of neurodevelopmental problems in childhood such as epilepsy and autism, but this is, to our knowledge, the first study to examine the potential for dementia later in adult life,” Carina N. Bagge, BSc, medical student in the department of clinical epidemiology at Aarhus University Hospital in Denmark, said in a press release.
Researchers analyzed data from 10,632 patients (46% men) with congenital heart disease who were alive at age 30 years. Data from patients who were diagnosed with congenital heart disease between 1963 and 1974 were retrieved from medical records review, and those diagnosed between 1977 and 2012 were from the Danish National Patient Registry.
Each patient with congenital heart disease was matched with 10 patients from the general population based on birth year and sex. Data were from the Civil Registration System.
The primary outcome of interest was first-time hospital diagnosis of all-cause dementia after age 30 years in an inpatient or outpatient setting. The threshold of age 65 years was used to categorize diagnoses by early and late-onset dementia.
Patients were followed up until they moved abroad, were diagnosed with dementia, died or when the study ended, whichever came first.
During follow-up, 4% of participants from both cohorts were diagnosed with dementia by age 80 years.
Compared with the general population cohort, the overall HR for dementia in adults with congenital heart disease was 1.61 (95% CI, 1.29-2.02). This did not differ between men (HR = 1.55; 95% CI, 1.06-2.26) and women (HR = 1.65; 95% CI, 1.25-2.19).
Patients with mild to moderate congenital heart disease complexity had an HR of 1.5 (95% CI, 1.14-1.97), whereas the HR in those with severe and univentricular congenital heart disease was 1.96 (95% CI, 1.15-3.34). Those with congenital heart disease who did not have extracardiac defects had an HR of 1.38 (95% CI, 1.08-1.76).
The HR for early-onset dementia was higher (HR = 2.6; 95% CI, 1.8-3.8) compared with late-onset dementia (HR = 1.3; 95% CI, 1-1.8).
“Adults with [congenital heart disease] acquire cardiovascular morbidities earlier than members of the general population, which may impact the brain reserve,” Bagge and colleagues wrote. “These morbidities, which include atrial fibrillation, stroke, diabetes mellitus, coronary artery disease and heart failure, are associated with an enhanced risk of cognitive decline and dementia.” – by Darlene Dobkowski