Abstract

Aim: A Review of literature on Ischemic Heart Disease and Risk of Development of
Cognitive Disorders
Methods: The literature search was conducted in Medline, Embase, PsycINFO, and
CINAHL. The search string consisted of predictor-related terms (e.g. myocardial
infarction, angina pectoris), outcome-related terms (e.g. dementia, Alzheimer, cognition),
as well as some specific limitations. All publications until 2021 were included if they
fulfilled the following eligibility criteria: 1) MI, AP, or a CHD variable that is a
combination of MI and AP (e.g. ischemic heart disease (IHD)) as predictor variable; 2)
cognition, cognitive impairment or dementia as outcome; 3) population-based study; 4)
prospective (≥1 year follow-up), cross-sectional or case-control study design; 5) ≥100
participants; and 6) aged ≥45 years. Reference lists of publications and secondary
literature were hand-searched for possible missing articles.
Results: The search yielded 3500 abstracts, of which (number***) were included in this
study. This resulted in 5 cross-sectional studies, 3 case-control studies, 6 prospective cohort
studies and 1 study with both cross-sectional and prospective analyses (designated as crosssectional
regarding study quality). Quality assessment of all 15 included studies was
sufficient (overall mean NOS score = 6.7, SD = 1.30, range = 3–10). Separate analyses for
each study design showed similar results for prospective (mean NOS score = 6.92, SD =
1.14, range = 5–9) and cross-sectional studies (mean NOS score = 7.23, SD = 0.98, range =
6–8), but the quality of case-control studies was somewhat lower (mean NOS score = 5.9,
SD = 1.93, range = 3–7), mainly due to the effects of one particular study with a score of 3.
Conclusion: We concluded that the CHD was associated with an increased risk of
cognitive impairment or dementia in prospective cohort studies. More mechanistic studies
are needed that focus on the underlying biological pathways (e.g. left ventricular
dysfunction, cerebral small vessel disease, hypoperfusio