Childhood heart defects linked to dementia praecox

(Reuters Health) – – People who survive childhood heart defects may have an increased risk of developing dementia before the age of 65, a Danish study has found.

“Previous studies have shown that people born with heart defects. . . may be at higher risk for childhood neurodevelopmental problems, such as epilepsy and autism, but this is, to our knowledge, the first study to examine the potential for dementia later in life adult,” said the study’s lead author, Carina Bagge, of Aarhus University Hospital. in Denmark.

Compared to people born with a normal heart, adult survivors of childhood heart defects were more than twice as likely to develop so-called dementia praecox by age 65, according to the current study. These survivors were also 30% more likely to develop dementia after age 65.

The risk of dementia increased with the severity of heart defects. Mild to moderate malformations were associated with a 50% higher chance of dementia, while the risks were doubled with severe malformations.

“We believe this study expands knowledge about long-term neurological disorders and brain health,” Bagge said by email. “It will become increasingly important to understand the risks and challenges across the lifespan in the growing and aging group of adults living with congenital heart disease.”

Congenital heart disease can include structural defects like a hole in the heart, leaky valves, and faulty vessels. These are among the most common birth defects, occurring in up to 1 in 100 live births, researchers note in Circulation.

Some cases are mild with few or no symptoms or can be treated with drugs to lower blood pressure or control heart rate, while more severe cases may require surgery or a heart transplant.

For the current study, the researchers looked at data from 10,632 cases of dementia diagnosed in Danish adults born with the heart defects, mostly after 1960. They paired each of these patients with 10 people of the same gender born in the same year. who had no heart defects. .

The most common type of heart defect was so-called atrial septal defects, a hole in the wall between the upper chambers of the heart, which accounted for 26% of cases. Ventricular septal defects, or a hole in the wall between the lower chambers, accounted for 22% of cases.

Overall, 4% of people in the study developed dementia by age 80.

By age 80, 60% of people with heart defects had died, compared to 35% of people born without these problems.

The study was not a controlled experiment designed to prove if or how a heart defect at birth could directly cause dementia or trigger its development earlier.

Also, the authors note, the results may not reflect what would happen with children born today who have a greater range of treatment options and better chances of survival than babies with heart defects there. has a generation.

Even so, the findings add to growing evidence that heart problems can also affect the brain, said Dr. Ralph Sacco, chief of neurology at the Miller School of Medicine at the University of Miami, Florida, and a former president of the American Heart Association. .

“Congenital heart disease that causes decreased heart function could lead to decreased blood flow to the brain, strokes and other vascular diseases that affect the brain,” said Sacco, who did not participate in the study, by e-mail.

Survivors can help minimize their risk of dementia by adopting a heart-healthy lifestyle, Sacco noted.

This includes maintaining a healthy weight, exercising, avoiding cigarettes, and checking and controlling blood pressure, cholesterol, and blood sugar. It also involves following a diet rich in whole grains, fruits, vegetables, poultry, and fish with little soda, sugary treats, and red meat.

“Congenital heart disease survivors need to be even more vigilant to maintain ideal cardiovascular health,” Sacco said.

SOURCE: bit.ly/2Exh255 Broadcast, online February 12, 2018.