Coronary heart disease, heart failure, and the risk of dementia: A systematic review and meta-analysis

Alzheimers Dement. 2018 Nov;14(11):1493-1504. doi: 10.1016/j.jalz.2018.01.007. Epub 2018 Mar 2.


Introduction: Cardiovascular risk factors are closely linked with dementia risk, but whether heart disease predisposes to dementia is uncertain.

Methods: We systematically reviewed the literature and meta-analyzed risk estimates from longitudinal studies reporting the association of coronary heart disease (CHD) or heart failure (HF) with risk of dementia.

Results: We identified 16 studies (1,309,483 individuals) regarding CHD, and seven studies (1,958,702 individuals) about HF. A history of CHD was associated with a 27% increased risk of dementia (pooled relative risk [RR] [95% confidence interval, CI]: 1.27 [1.07-1.50]), albeit with considerable heterogeneity across studies (I2 = 80%). HF was associated with 60% increased dementia risk (pooled RR 1.60 [1.19-2.13]) with moderate heterogeneity (I2 = 59%). Among prospective population-based cohorts, pooled estimates were similar (for CHD, RR 1.26 [1.06-1.49], nine studies; and HF, RR 1.80 [1.41-2.31], four studies) and highly consistent (I2 = 0%).

Conclusion: CHD and HF are associated with an increased risk of dementia.

Keywords: Alzheimer's disease; Coronary heart disease; Dementia; Heart failure; Myocardial infarction.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Coronary Disease / epidemiology*
  • Dementia / epidemiology*
  • Heart Failure / epidemiology*
  • Humans
  • Risk