The study assessed mental performance for any mental decline in 220 patients hospitalized for a heart attack in Poznan, Poland. Patients underwent two cognitive assessments a few days after the heart attack and then repeated the tests six months later. The two tests, the Mini Mental State Test and the Clock Drawing Test, assess a person’s thinking, memory, and ability to perform basic tasks and are commonly used to diagnose diagnose symptoms of dementia.
Trials showed that about 50% of patients overall had normal cognitive function at both time points, while the other half had cognitive impairment.
About 35% to 40% of patients show cognitive decline in the first days after a heart attack, while 27% to 33% show a decline after six months. In some patients with cognitive decline after a heart attack, the risk is temporary in half of the cases and permanent in the other half. One in nine patients had normal cognitive function immediately after the heart attack, but showed cognitive decline six months later.
Cognitive disorders can affect a person’s quality of life and it can be difficult to pursue treatments and lifestyle changes to help prevent a second heart attack. Therefore, it is important for cardiologists to be on the lookout for symptoms of mental decline, as Kasprzak says.
“Cognitive impairment, such as memory loss or inability to recognize loved ones, may be even more important to our patients than their cardiovascular disease,“Kasprzak said.”We need to monitor patients regularly to detect changes in their functioning, not only in the heart but also in the brain.“
None of the study participants had a history of memory loss or cognitive disturbances prior to the heart attack. Although researchers have not tried to determine
Kasprzak thinks the causes of depression they’ve observed may be working because the permanent effects counteract the temporary effects. For example, psychological stress and sleep disturbances during a heart attack may contribute to temporary impairment of function, while permanent effects may indicate neurosurgery or brain damage. Factors such as sleep disturbances, depression, and anxiety may play a role in patients’ late decline in health in the months following a heart attack.
Because the study participants were relatively young — age 60 on average — normal age-related declines alone could not explain the patients’ larger cognitive decline, Kasprag said. However, age can exacerbate the effects. Elderly patients and patients with blood markers indicative of more severe heart disease are more likely to have permanent cognitive impairment.
Researchers are now analyzing data from a follow-up study to further explore cognitive trends following heart attacks and the causes that lead to these effects. The team also plans to develop a highly effective assessment tool that cardiologists can use to diagnose cognitive impairment during routine follow-up visits.