Three common heart conditions—heart failure, atrial fibrillation, and coronary heart disease—are closely linked to cognitive decline and a higher risk of dementia, according to a new scientific statement from the American Heart Association, published in Stroke.
The statement reviews the latest evidence on how heart health and brain health are interconnected, emphasizing the importance of managing cardiovascular health to protect cognitive function.
Dr. Fernando D. Testai, a neurologist and stroke expert from the University of Illinois, highlights the significance of this relationship. “Stroke and cognitive decline are chronic, disabling conditions with wide-ranging impacts.
Managing heart health early in life can help prevent cardiovascular issues, protect brain health, and reduce the risk of dementia,” he explained.
While dementia is often seen as inevitable, research shows that adopting a healthy lifestyle and addressing vascular risk factors early may help preserve brain function and reduce the burden of diseases like Alzheimer’s.
Heart Failure and Cognitive Decline
Heart failure is a widespread condition caused by issues like high blood pressure, obesity, and Type 2 diabetes.
It significantly affects cognitive abilities such as memory and decision-making, with nearly half of people with heart failure experiencing some degree of cognitive impairment. The severity of cognitive decline often correlates with the severity of heart failure.
The condition affects the brain in several ways. Reduced blood flow can lead to small, silent strokes and brain injuries. Chronic inflammation and hormonal imbalances further damage brain tissues.
Conditions like obesity and sleep disorders, common in heart failure patients, also contribute to cognitive issues. Brain scans of heart failure patients often reveal reduced gray matter and white matter damage, which impair brain function.
Patients with severe heart failure are advised to undergo cognitive screening before undergoing major treatments, as they are at higher risk of strokes, a key driver of cognitive decline.
Atrial Fibrillation and the Brain
Atrial fibrillation, a common irregular heart rhythm, affects millions of adults and is expected to become more prevalent in the coming decades.
It is strongly linked to strokes, which are a leading cause of cognitive decline. People with atrial fibrillation are 39% more likely to experience cognitive impairment, even without suffering a major stroke.
Shared risk factors, including high blood pressure, diabetes, and smoking, contribute to both atrial fibrillation and dementia.
Reduced blood flow, microbleeds in the brain, and systemic inflammation are among the mechanisms linking the two conditions. Inflammation can increase the risk of blood clots and brain injury, further impacting cognitive health.
Treating atrial fibrillation through medications, procedures like catheter ablation, or anti-clotting therapies may help reduce the risk of cognitive decline. Researchers are exploring whether restoring a normal heart rhythm can have greater benefits for brain health than medication alone.
Coronary Heart Disease and Dementia Risk
Coronary heart disease, caused by the narrowing of blood vessels that supply the heart, is another major risk factor for dementia. Studies involving over a million participants show that heart disease increases the likelihood of developing dementia by 27%.
After a heart attack, as many as half of patients experience cognitive challenges, including memory problems and difficulties with planning and decision-making.
Heart disease harms the brain by reducing blood flow, causing inflammation, and damaging small blood vessels in the brain.
These effects overlap with those seen in Alzheimer’s disease, highlighting the close connection between vascular health and brain health. Genetic factors that predispose individuals to heart disease may also contribute to brain shrinkage and cognitive decline.
While more research is needed to fully understand these links, managing vascular risk factors like high blood pressure and diabetes may help protect cognitive health.
Lifestyle changes, including a healthy diet and regular exercise, can also play a significant role in reducing the risk of both heart disease and dementia.
Prevention Is Key
The findings reinforce the idea that prevention is better than cure. While new treatments for Alzheimer’s are being developed, improving heart health earlier in life remains one of the best ways to protect brain function.
Dr. Testai stresses the importance of a holistic approach to health, promoting healthy habits and monitoring cardiovascular risk factors throughout life.
Additionally, more research is needed to understand how factors like gender, race, and ethnicity affect the heart-brain connection. By focusing on heart health, individuals can take meaningful steps to reduce the risk of cognitive decline and maintain overall well-being as they age.
If you care about heart disease, please read studies that herbal supplements could harm your heart rhythm, and how eating eggs can help reduce heart disease risk.
For more health information, please see recent studies that apple juice could benefit your heart health, and results showing yogurt may help lower the death risks in heart disease.
The research findings can be found in Stroke.
Copyright © 2025 Knowridge Science Report. All rights reserved.
