Keeping your brain sharp as you age has a lot to do with your heart — and the younger you start taking better care of it, the better — according to a new scientific statement published Thursday by the American Heart Association.
“Dementia is commonly seen as an incurable and relentless disease that cannot be prevented,” said Dr. Fernando Testai, a professor of neurology and rehabilitation at the University of Illinois College of Medicine in Chicago, in a statement.
“Evidence shows, however, that adopting a healthy lifestyle and identifying and treating vascular risk factors early may help preserve normal brain function and reduce the burden of Alzheimer’s disease and other related dementias,” said Testai, who chaired the statement writing group.
Nearly 130 million adults in the United States have some form of heart disease, according to the AHA. Adopting a heart-heathy lifestyle should start early in life, even before a baby is born, said Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver.
“This call to action is especially critical right now because so many Americans have some form of heart disease and people are getting sicker and sicker earlier in life,” said Freeman, who was not involved in writing the AHA statement.
“The typical American curse is that we all work hard our whole lives,” Freeman said. “We save our money, we get ready to retire, and then we look forward to heart attacks, strokes, dementia — diseases that are potentially avoidable if we can act early enough and change our lifestyles.”
Dementia and plaque in the arteries
Coronary heart disease, which is the buildup of plaque in the body’s arteries, is the lead killer in the world, according to the World Health Organization. Deaths from coronary artery disease have risen from 6.4 million in 2000 to 9.1 million in 2021, the WHO said.
The disease also takes a toll on the brain. The narrowing of arteries that occurs with coronary heart disease and high blood pressure can reduce blood flow and cause damage to the small blood vessels in the brain, resulting in cognitive impairment, the AHA said. High blood pressure and type 2 diabetes can also reduce blood flow to the brain and increase inflammation, leading to cognitive decline and dementia.
Having coronary heart disease raises the risk of future dementia by 27% compared with people without heart disease, the AHA statement said. The disease can start in a person’s 40s and 50s, often with no visible symptoms to alert a person of the danger.
Heart attacks and heart failure
About every 40 seconds, someone in the United States will have a heart attack, the AHA estimates. After that happens, up to 50% of those who survive experience loss of brain function, with some taking a sharper decline into cognitive impairment, the AHA statement said.
Heart failure is a more severe form of heart disease, in which the heart is too weak to pump enough blood and oxygen to the body’s organs. According to the new scientific statement, up to 81% of people with heart failure can have some form of cognitive decline that impacts their memory, language, or ability to think and plan.
“Emerging evidence suggests that the bidirectional relationship between the heart and the brain is deeper than we thought,” Testai said in an email. “Vascular risk factors associated with cardiac diseases, such as diabetes, can increase the levels of beta-amyloid in the brain. which is recognized as a key marker of Alzheimer’s disease.
“In return, beta-amyloid has been found in the heart and is associated with cardiac dysfunction,” he said. “These findings suggest a fundamental biochemical connection between the heart and the brain.”
A-fib and dementia
Known as A-fib, atrial fibrillation is an irregular heartbeat often described by many people who have it as a “quiver,” “flutter” or “flip-flop” of the heart in the chest.
Atrial fibrillation is the leading cause of stroke in the US. In addition, strokes connected to A-fib tend to be “more severe than strokes with other underlying causes,” according to the US Centers for Disease Control and Prevention.
Small brain bleeds, called microhemorrhages, that can lead to cognitive decline are more common in people with atrial fibrillation, according to the new scientific statement. In fact, people with A-fib have a 39% increased risk of memory or thinking problems.
Focus on lifestyle changes
Modern medicine has amazing drugs — such as statins and cholesterol-lowering medications — that can prevent or slow heart disease, especially if caught early, Freeman said. Regular checkups and taking prescribed medications on a daily basis are critical to making that happen, he added.
However, there is a limit on what drugs can accomplish. For example, aggressively treating high blood pressure has shown promise in reducing mild cognitive impairment but not dementia, the AHA statement said.
“Humans were designed to live very differently than we live today, and it’s an imperative that people understand how unbelievably important lifestyle is,” Freeman said.
What are the key lifestyle factors that boost brain health? Nothing you haven’t heard before.
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