Jens Sundbøll1,2, Erzsébet Horváth-Puhó3, Kasper Adelborg3,2, Morten Schmidt3,2, Lars Pedersen3, Hans Erik Bøtker2, Victor W Henderson3,4, Henrik T Sørensen3,4. 1. Department of Clinical Epidemiology (J.S., E.H.-P., K.A., M.S., L.P., V.W.H., H.T.S.) jens.sundboll@clin.au.dk. 2. Department of Cardiology (J.S., K.A., M.S., H.E.B.), Aarhus University Hospital, Denmark. 3. Department of Clinical Epidemiology (J.S., E.H.-P., K.A., M.S., L.P., V.W.H., H.T.S.). 4. Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences, Stanford University, CA (V.W.H., H.T.S.).
Abstract
BACKGROUND: Increased risk of dementia after myocardial infarction (MI) may be mediated by shared risk factors (eg, atherosclerosis) and post-MI stroke. We examined risk of dementia in 1-year survivors of MI. METHODS: Using Danish medical registries, we conducted a nationwide population-based cohort study of all patients with first-time MI and a sex-, birth year-, and calendar year-matched general population comparison cohort without MI (1980-2012). Cox regression analysis was used to compute 1- to 35-year adjusted hazard ratios (aHRs) for dementia, controlled for matching factors and adjusted for comorbidities and socioeconomic status. RESULTS: We identified 314 911 patients with MI and 1 573 193 matched comparison cohort members randomly sampled from the general population (median age, 70 years; 63% male). After 35 years of follow-up, the cumulative incidence of all-cause dementia in the MI cohort was 9% (2.8% for Alzheimer disease, 1.6% for vascular dementia, and 4.5% for other dementias). Compared with the general population cohort, MI was not associated with all-cause dementia (aHR, 1.01; 95% confidence interval [CI], 0.98-1.03). Risk of Alzheimer disease (aHR, 0.92; 95% CI, 0.88-0.95) and other dementias (aHR, 0.98; 95% CI, 0.95-1.01) also approximated unity. However, MI was associated with higher risk of vascular dementia (aHR, 1.35; 95% CI, 1.28-1.43), which was substantially strengthened for patients experiencing stroke after MI (aHR, 4.48; 95% CI, 3.29-6.12). CONCLUSIONS: MI was associated with higher risk of vascular dementia throughout follow-up, and this association was stronger in patients with stroke. The risk of Alzheimer disease and other dementias was not higher in patients with MI.
BACKGROUND: Increased risk of dementia after myocardial infarction (MI) may be mediated by shared risk factors (eg, atherosclerosis) and post-MI stroke. We examined risk of dementia in 1-year survivors of MI. METHODS: Using Danish medical registries, we conducted a nationwide population-based cohort study of all patients with first-time MI and a sex-, birth year-, and calendar year-matched general population comparison cohort without MI (1980-2012). Cox regression analysis was used to compute 1- to 35-year adjusted hazard ratios (aHRs) for dementia, controlled for matching factors and adjusted for comorbidities and socioeconomic status. RESULTS: We identified 314 911 patients with MI and 1 573 193 matched comparison cohort members randomly sampled from the general population (median age, 70 years; 63% male). After 35 years of follow-up, the cumulative incidence of all-cause dementia in the MI cohort was 9% (2.8% for Alzheimer disease, 1.6% for vascular dementia, and 4.5% for other dementias). Compared with the general population cohort, MI was not associated with all-cause dementia (aHR, 1.01; 95% confidence interval [CI], 0.98-1.03). Risk of Alzheimer disease (aHR, 0.92; 95% CI, 0.88-0.95) and other dementias (aHR, 0.98; 95% CI, 0.95-1.01) also approximated unity. However, MI was associated with higher risk of vascular dementia (aHR, 1.35; 95% CI, 1.28-1.43), which was substantially strengthened for patients experiencing stroke after MI (aHR, 4.48; 95% CI, 3.29-6.12). CONCLUSIONS: MI was associated with higher risk of vascular dementia throughout follow-up, and this association was stronger in patients with stroke. The risk of Alzheimer disease and other dementias was not higher in patients with MI.
Authors: Tatjana Rundek; Hannah Gardener; Anita Seixas Dias Saporta; David A Loewenstein; Ranjan Duara; Clinton B Wright; Chuanhui Dong; Bonnie Levin; Mitchell S V Elkind; Ralph L Sacco Journal: J Alzheimers Dis Date: 2020 Impact factor: 4.472
Authors: Cecilia S Lee; Michael L Lee; Laura E Gibbons; Ryan T Yanagihara; Marian Blazes; Jason P Kam; Susan M McCurry; James D Bowen; Wayne C McCormick; Aaron Y Lee; Eric B Larson; Paul K Crane Journal: J Alzheimers Dis Date: 2021 Impact factor: 4.472
Authors: Christopher L Schaich; Joseph Yeboah; Mark A Espeland; Laura D Baker; Jingzhong Ding; Kathleen M Hayden; Bonnie C Sachs; Suzanne Craft; Stephen R Rapp; José A Luchsinger; Annette L Fitzpatrick; Susan R Heckbert; Wendy S Post; Gregory L Burke; Norrina B Allen; Timothy M Hughes Journal: J Gerontol A Biol Sci Med Sci Date: 2022-06-01 Impact factor: 6.591