In a new study, researchers found that people who have mild cognitive impairment (MCI), which lies on the continuum of cognitive decline between normal cognition and dementia, are less likely to receive proven heart attack treatment in the hospital.
They found no evidence that those with MCI would derive less benefit from evidence-based treatment that’s offered to their cognitively normal peers who have heart attacks.
The research was conducted by a team from Michigan Medicine.
Some people with thinking, memory, and language problems have mild cognitive impairment.
Unlike dementia, which severely interferes with daily functioning and worsens over time, mild cognitive impairment does not severely interfere with daily functioning and might not worsen over time.
Although people with mild cognitive impairment have an increased risk of developing dementia, it’s not an inevitable next step.
Many older adults with mild cognitive impairment live years with good quality of life, and so face common health risks of aging like heart attack and stroke.
In the study, the team measured 609 adults ages 65 and older who were hospitalized for a heart attack between 2000 and 2011.
They found pre-existing MCI was associated with much lower use of guideline-concordant care after a heart attack, whether catheter-based or open surgery.
The team says both cardiac catheterization (35% less likely in patients with pre-existing MCI) and coronary revascularization (45% less likely in patients with pre-existing MCI) have been shown to be highly effective at reducing deaths and improving physical functioning after heart attacks.
Patients should get the treatments they would want if they were properly informed.
Clinicians, patients, and families might be overestimating the risk of dementia after a mild cognitive impairment diagnosis even without realizing it.
These older adults with mild cognitive impairment should still receive evidence-based treatments when indicated.
The lead author of the study is Deborah Levine, M.D., MPH.
The study is published in the Journal of General Internal Medicine.
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