CMHC Pulse Blog

Congenital Heart Disease Increases Dementia Risk

A recent study published in Circulation indicates that people with congenital heart disease showed an elevated risk for dementia, particularly early-onset dementia, compared with the general population. A press release published by Aarhus University Hospital in Denmark stated: “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… the first study to examine the potential for dementia later in adult life.”

Researchers analyzed data from 10,632 patients with congenital heart disease who were alive at 30 years old, and retrieved data from patients diagnosed with congenital heart disease between 1963 and 1974. Data was used from both medical records review and the Danish National Patient Registry; each patient with congenital heart disease was matched with 10 patients from the general population.

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.

Researchers followed up with patients until they moved abroad, were diagnosed with dementia, died, or when the study concluded. During follow-up, 4% of participants from both cohorts were diagnosed with dementia by 80 years old. 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)–which did not differ between men and women.

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,” wrote the researchers. “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.”

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