Higher Risk of Vascular Dementia in Myocardial Infarction Survivors

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Background -Increased risk of dementia after myocardial infarction (MI) may be mediated by shared risk factors (e.g., 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 1-35 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's 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's 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 asssociation was stronger in patients suffering stroke. The risk of Alzheimer's disease and other dementias was not higher in MI patients.

Original languageEnglish
JournalCirculation
Volume137
Issue number4
ISSN0009-7322
DOIs
StatePublished - 23 Jan 2018

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