Those with low critical thinking abilities more likely to have heart attack and stroke
A new study in Europe has found that older people with poor decision-making and problem-solving skills suffer a high chance of getting a heart attack or stroke.
Having low thinking skills also point to previous vascular damage in the brain.
“This might reflect that damage to the vessels is a global phenomenon in our body and when we see abnormalities in one organ we should think about the other organs as well,” Dr. Behnam Sabayan of Leiden University Medical Center in the Netherlands said.
“This is another line of evidence showing that pathologies at the levels of heart or the brain are not independent.”
Neurologists and cardiologists should collaborate for early detection of older people at risk for either cardiac or brain vascular disorders, he said.
Researchers studied 3,926 older people in the Netherlands, Ireland and Scotland. The average age was 75 years old, and participants had either a history of heart disease or an increased risk for it due to high blood pressure, diabetes or smoking, but no history of an actual heart attack or stroke.
The researchers used four tests to assess the participants’ selective attention, decision processing speed, immediate memory and delayed memory.
Over three years of follow-up there were 375 coronary events, including heart attacks or deaths due to heart disease, and 155 strokes in the group.
The researchers divided the participants equally into three groups based on their executive function skills scores at the beginning of the study. Those in the lowest-scoring third were 85 % more likely to develop coronary heart disease and 51 % more likely to have a stroke than those in the highest-scoring third.
Those with lower scores were at higher risk even when the researchers accounted for age, gender, education, body mass index, blood pressure, total cholesterol, current smoking and history of diabetes.
There were 69 strokes in the low-scoring group, compared with 48 strokes among those with high scores.
Scores on the memory tests did not appear to be related to heart attack or stroke risk, the study team reports in Neurology.
“This is just adding to the evidence to support what we already know, there is a relationship between cardiovascular risk factors and cognition,” said Dr. Olaoluwa Okusaga of the University of Texas-Harris County Psychiatric Center in Houston, who was not part of the new study.
“This study is novel in that they identified a specific domain, executive function, as being predictive of cardiovascular risk,” Okusaga said.
Executive function includes making decisions and weighing options, so it could be that people with lower decision-making scores make poorer decisions in their daily lives that make them more prone to heart attack or stroke, he said.
Before doctors change what they do, this study should be replicated, he noted, but in the meantime, keeping mentally active by doing things like puzzles may help prevent cognitive decline.
Unlike innate intelligence, or IQ, cognitive abilities can change over time and are more vulnerable to exposure to factors like uncontrolled blood pressure in midlife, Sabayan said.
Older people with slower thought processing are less likely to follow physicians’ lifestyle and medical recommendations, he said.
“Therefore, our findings highlight that older subjects with impaired cognition need closer attention in terms of cardiovascular risk management,” he said.
“This does not mean that everyone should undergo cognitive assessment to determine their heart attack or stroke risk, instead it means when older patients present with cognitive problems their physician should take into account risk of future cardiovascular events and provide preventive care,” he said.
Category: Features, Health alert
