Myocardial Infarction Bends the Curve of Age-Related Cognitive Decline

In this issue of JAMA Neurology, Johansen et al reported that there was an acceleration of age-related cognitive decline following acute myocardial infarction (MI). In an analysis of more than 30  000 persons pooled from 6 major US epidemiological cohort studies, the 1033 individuals who had an MI during study follow-up had a steeper annual decline in cognition after the MI compared with before the MI. As expected, all persons with or without MI had a small age-related annual decline in co gnition. This age dependence is a feature of most neuropsychological tests. However, after MI, the annual rate of decline accelerated, being steeper than in the same individual before their MI and steeper than in individuals who never had an MI. Interestingly, the long-term slope of the decline chan ged after MI despite no immediate stepwise drop. A steeper post-MI annual rate of decline was seen in White individuals compared with Black individuals and in men compared with women. The increased rate of annual decline could not be explained by stroke or new atrial fibrillation. So, what mechanism s might be involved?
Source: JAMA Neurology - Category: Neurology Source Type: research