The interaction and pathogenesis between cognitive impairment and common cardiovascular diseases in the elderly

Abstract

Both cognitive impairment and cardiovascular diseases have a high incidence in the elderly population, increasing the burden of care and reducing the quality of life. Studies have suggested that cognitive impairment interacts with cardiovascular diseases such as coronary heart disease, abnormal blood pressure, heart failure, and arrhythmia. On one hand, cognitive impairment in the elderly influences the progression and self-management of cardiovascular diseases and increases the risk of cardiovascular-related adverse events. On the other hand, coronary heart disease, heart failure, higher blood pressure variability, orthostatic hypotension, and atrial fibrillation may aggravate cognitive impairment. The role of blood pressure levels on cognition remains controversial. Several shared biological pathways have been proposed as the underlying mechanism for the association. Cardiovascular diseases may lead to cognitive decline even dementia through cerebral perfusion damage, brain structural changes, inflammation, β-amyloid deposition, and neuroendocrine disorders. It is of great significance to study the interaction and put forward effective interventions in an overall perspective to reduce care burden and improve the quality of life of the elderly patients.

Keywords: aging; cardiovascular diseases; cognitive impairment; pathogenesis.

Figure 1.

The vicious cycle of cardiovascular diseases and cognitive impairment. It is generally believed that above CVDs accelerate the decline of cognitive function. In turn, the impairment of above cognitive domains increases the risk of CVDs or aggravates the prognosis of them. BPV, blood pressure variability.

Figure 2.

Systematic overview on pathogenesis of cognitive impairment caused by cardiovascular diseases in the elderly. BDNF, brain-derived neurotrophic factor; NO, nitric oxide; RAAS, renin-angiotensin-aldosterone system.