Prior heart attack linked to faster declines in thinking and memory skills: Study

The chance of developing cognitive impairment was significantly higher for people who have had a heart attack, according to a study published today in Stroke, the peer-reviewed scientific journal of the American Stroke Association, a division of the American Heart Association.

“Having had a heart attack in the past may speed up the decline in memory and thinking over time,” said study lead author Mohamed Ridha, M.D., an assistant professor of neurology at The Ohio State University in Columbus, Ohio. “Given the rising burden of dementia and cognitive decline among Americans, it is important to understand how cardiovascular disease affects their brain health. This knowledge can help heart attack survivors take steps to improve their brain health as they age.”

In this study, researchers examined the potential relationship between a prior history of heart attack and the trajectory of cognitive function over time. The study included more than 20,000 adult men and women who underwent a medical interview and electrocardiogram at the start of the study to determine if they had a heart attack at any point in their past.

Over a 10-year follow-up period, participants underwent a simple cognitive screening with 6 questions once per year. The analysis adjusted for all factors that contribute to cognitive decline to identify the true impact of a prior heart attack.

The analysis found:

• Compared to people without a previous heart attack, heart attack survivors had an average yearly 5% increased odds of developing cognitive impairment. This association was similar among Black and white adults, as well as men and women.
• People with an undiagnosed (silent) heart attack were also found to have an accelerated rate of cognitive decline, compared to participants who had not had a heart attack.
• Among women, a silent heart attack was more common than a medical diagnosis or self-reported heart attack.

“As people age, the risk of cognitive issues and dementia increases, and some people may be at higher risk of cognitive decline. Our study found that those who have had a heart attack, including silent heart attacks, are one of those groups at higher risk. It’s important for clinicians who care for heart attack survivors to also provide counseling on ways to avoid cognitive decline and dementia,” Ridha said.

The American Heart Association defines optimal heart and brain health through its Life’s Essential 8™ metrics — four health behaviors (eat better, be more active, quit tobacco and get healthy sleep) and four health factors (healthy weight and manage cholesterol, blood pressure and blood sugar). This study adds more evidence that good heart health is linked to better brain health.

“This study highlights a group of people who may be at higher risk for conditions that affect memory and thinking over time,” said Elisabeth Marsh, M.D., FAHA, chair of the 2026 American Heart Association Scientific Statement Brain Health Across the Lifespan. “A previous heart attack may be a sign of more widespread blood vessel disease throughout the body, not just in the heart. However, more research is needed to better understand what’s really driving this connection and how damage in different blood vessels may be linked to changes in brain health.” Marsh, who was not involved in this research, is a professor of neurology and associate director of the neurology residency program at The Johns Hopkins University School of Medicine and director of the Stroke Center at Johns Hopkins Bayview Medical Center in Baltimore.

To address the growing burden of age-related cognitive impairment, the American Heart Association and the Paul G. Allen Frontiers Group have created the AHA-Allen Initiative in Brain Health and Cognitive Impairment. The two organizations, along with additional contributors, have committed more than $43 million toward research to advance the understanding of brain health and improve lives. More information about the awards given to fund brain health research is available here. In addition, the Association’s Strategically Focused Research Network on Inflammation in Cardiac and Neurovascular Disease awarded $15 million to researchers to study inflammation’s impact on heart and brain health.

Reference:

Mohamed Ridha, Musarrat Nahid, Prior Myocardial Infarction and Cognitive Decline: The REGARDS Cohort, Stroke, https://doi.org/10.1161/STROKEAHA.125.053444