European Journal of Molecular & Clinical Medicine

Abstract

Aim: A Review of literature on Ischemic Heart Disease and Risk of Development of
Cognitive Disorders
Methods: The literature search was conducted in Medline, Embase, PsycINFO, and
CINAHL. The search string consisted of predictor-related terms (i.e. myocardial
infarction, angina pectoris), outcome-related terms (i.e. dementia, Alzheimer,
cognition), as well as some specific limitations. All publications until 2021 were included
if they fulfilled the following eligibility criteria:
1) MI, AP, or a CHD variable that is a combination of MI and AP (e.g. ischemic heart
disease (IHD) 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.
Results: The search yielded 3500 abstracts, of which 15 were included in this study. This
resulted in 5 cross-sectional studies, 3 case-control studies, 6 prospective cohort studies
and 1 study with both cross-sectional and prospective analyses (designated as crosssectional
regarding study quality). Quality assessment of all 15 included studies was
sufficient (overall mean NOS score = 6.7, SD = 1.30, range = 3–10). Separate analyses
for each study design showed similar results for prospective (mean NOS score = 6.92,
SD = 1.14, range = 5–9) and cross-sectional studies (mean NOS score = 7.23, SD = 0.98,
range = 6–8), but the quality of case-control studies was somewhat lower (mean NOS
score = 5.9, SD = 1.93, range = 3–7), mainly due to the effects of one particular study
with a score of 3.
Conclusion: We concluded that the CHD was associated with an increased risk of
cognitive impairment or dementia in prospective cohort studies. More mechanistic
studies are needed that focus on the underlying biological pathways (e.g. left ventricular
dysfunction, cerebral small vessel disease, hypoperfusion) and shared risks that link
CHD with the occurrence of cognitive impairment or dementia.