Heart Disease Raises Dementia Risk
Are women at higher risk than men?
PULSE Issue 41 | July 2023
Are you ruled by your head or your heart?
There is scientific basis for the heart-brain axis that
is no longer a mere sensational metaphor. Evolving
research has shown that women with heart disease
are strongly linked to cognitive decline (Dementia),
more so than men.
Dementia is a general term describing conditions which
lead to a decline in the mental ability, severe enough to
disrupt daily life. Dementia is not a normal part of aging
and is instead, caused by damage to brain tissues which
affects thinking, behaviour and feelings. There are different types of Dementia including Alzheimer’s Disease,
Vascular Dementia and Lewy Body Dementia.
In the recent Well-being of the Singapore Elderly (WiSE)
nationwide study, the prevalence of Dementia was
found to be one in every 10 people aged 60 years and
above. This disease is well-known to affect more women
than men, where two out of three people with Alzheimer’s Disease are women.
It is also strongly associated with various cardiovascular
disorders. Heart and brain disorders more frequently
co-exist than by chance alone, due to having common
risk factors and a degree of interaction.
Women with history of heart disease are more likely to
experience cognitive loss with age.
There has been increasing evidence on a broad scale
documenting women’s predisposition to Dementia with
heart-related issues. This is especially so for older and
postmenopausal women.
In a long term study published in the Journal of the American Heart Association, of more than 6,000 women aged
65-79, female heart attack survivors are twice as likely to
experience decline in memory and cognition.
In another population-based cohort study of more than
500,000 individuals, data showed that women with Coronary Heart Disease and Heart Failure were 1.6 and 1.3 times
more likely to develop Alzheimer’s Disease than men with
the same condition.
Even without Heart Disease, women with Hypertension and
Diabetes are at a higher risk of cognitive decline than men.
The usual risk factors for Heart Disease and Stroke, applies
to Dementia too.
Heart Disease is more than just blocked or damaged arteries,
it is also an inflammatory process that can affect the turnover of brain cells, leading to small bits of tissue death in the
brain over time.
WOMEN ARE MORE LIKELY TO
HAVE RISK FACTORS LINKED TO
INCREASED RISK OF DEMENTIA,
SUCH AS:
- Increased prevalence/severity
of Hypertension & Diabetes
(especially >64 years old)
- Increased Stroke Risk with Atrial Fibrillation (AF), Bypass Surgery,
Aortic Valve Procedures: When it comes to stroke prevention for
those with AF, women were found to
have been less aggressively treated with
blood thinners than men were.
Women are also found
to have higher rates of
stroke when undergoing
Heart Bypass Surgery
and Transcatheter Aortic
Valve Procedures, but
reasons for this difference
is still unclear.
- Systemic Inflammation
- Microvascular (small
coronary vessel)
Disease / Dysfunction
- Oestrogen / Androgen
(sex hormone) balance
- Physical inactivity
and obesity
- Increased longevity: As women generally have a longer life
expectancy than men, women are more
at risk of developing Dementia with
age. Unfortunately, this also means that
women living with
heart disease and
Dementia carry a
larger burden of disease in their lifespan
compared to men.
Heart disease is reversible, dementia is not
80% of Cardiovascular Disease is preventable by having a
healthy lifestyle.
Everyone, men or women, can do their part by maintaining a healthy diet by incorporating a daily intake of such as
fresh fruits and vegetables, staying physically and mentally
active, and paying attention to their blood pressure, blood
sugar and cholesterol levels.
All these efforts can not only prevent Heart Disease, but also
prevent cognitive impairment and Dementia.
Learn more about NUHCS Women's Heart Health Programme.
