According to new research published in the American Heart Association’s journal Circulation, adults with congential heart disease (CHD) could be at a higher risk of developing dementia compared with the general population, particularly for early onset dementia. The Danish cohort study, included 10, 632 CHD survivors in the sample; for each CHD adult, 10 individuals from the general population were randomly sampled and matched on sex and birth year.
This study found the risk of all-cause dementia was increased by =60% compared with a matched general population cohort. The risk was higher for early onset dementia (under 65 years of age; more than double) than late-onset dementia (=30% elevated risk) and was elevated for all levels of congenital heart disease complexity, including those with cyanotic potential.
The study’s key findings are:
- Adults with congenital heart disease are at increased risk for dementia, particularly early onset dementia, and these results support the importance of understanding the risk of adverse long-term neurological outcomes in the growing and aging population with congenital heart disease.
- Although it remains unknown whether the results are directly generalizable to children diagnosed today, they appear relevant for the large population
of adults with congenital heart disease alive today.
- In the absence of disease-modifying treatments for most dementias, the specific influence of etiologic factors on congenital heart disease is a potential
target for future investigations to delay dementia onset in this vulnerable population
Background—More children with congenital heart disease (CHD) are surviving to adulthood, and CHD is associated with risk factors for dementia. We compared the risk of dementia in CHD adults to that of the general population.
Methods—In this cohort study, we used medical registries and a medical record review covering all Danish hospitals to identify adults with CHD diagnosed between 1963 and 2012. These individuals with CHD were followed from January 1, 1981, 30 years of age, or date of first CHD registration (index date for matched members of the general population cohort) until hospital diagnosis of dementia, death, emigration, or end of study (December 31, 2012). For each individual with CHD, we identified 10 members of the general population utilizing the Danish Civil Registration System matched on sex and birth year. We computed cumulative incidences and hazard ratios (HRs) of dementia, adjusting for sex and birth year.
Results—The cumulative incidence of dementia was 4% by 80 years of age in 10 632 adults with CHD (46% male). The overall HR comparing adults with CHD with the general population cohort was 1.6 (95% confidence interval [CI], 1.3−2.0). The HR among individuals with CHD without extracardiac defects was 1.4 (95% CI, 1.1−1.8). Adults with mild-to-moderate CHD had an HR of 1.5 (95% CI, 1.1−2.0), whereas the HR was 2.0 (95% CI, 1.2−3.3) for severe CHD, including univentricular hearts. The HR for early onset dementia (under 65 years of age) was 2.6 (95% CI, 1.8−3.8), whereas the late-onset HR was 1.3 (95% CI, 1.0−1.8).
Conclusions—CHD was associated with an increased risk of dementia compared with the general population, in particular for early onset dementia. Further understanding of dementia risk in the population with CHD is a potential target for future investigation.
Abstract from American Heart Association’s Circulation
Full reference: Doi: https://doi.org/10.1161/CIRCULATIONAHA.117.029686, C. N. et al | Risk of Dementia in Adults with Congenital Heart Disease: Population- Based Cohort Study | Circulation |
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