More than 70% of people over the age of 70 will develop heart disease at some point in their lives.
This number shows just how important it is to find better ways to diagnose and treat heart problems in older adults.
But while many treatments focus on the heart, there’s another health issue that older adults care deeply about: their brain.
Dr. Michael Nanna, a heart doctor and researcher at Yale, says that when he talks to older patients with heart disease, many of them say their biggest health goal is not just living longer, but staying mentally sharp and avoiding dementia. Despite this, there hasn’t been much research connecting heart health and brain health—until now.
Dr. Nanna recently published a study in the Journal of the American Heart Association. In this study, he and his team created new tools to help predict whether older adults are at risk for both heart disease and cognitive decline, including memory loss and conditions like Alzheimer’s.
He explained that heart disease and dementia actually share many of the same risk factors. These include things like high blood pressure, diabetes, smoking, and lack of exercise. If you look at the list of things that increase the risk of dementia, it’s almost identical to the list that doctors use to check for heart problems.
In fact, studies suggest that up to 40% of dementia cases might be preventable by changing these risk factors. That’s why Dr. Nanna wanted to build better tools to help people understand their personal risks—so they can take steps to prevent both heart disease and memory loss.
One of the problems with older prediction tools is that they were designed for younger people. For example, a heart risk calculator might work well for someone who is 40, but not for someone who is 80. The signs doctors look for in middle-aged adults don’t always tell us what’s going to happen in older patients.
So Dr. Nanna and his team developed new models that focus on the things that matter most to older people—like brain function and daily independence.
They included new indicators in their models, such as how easily a person can move around, or whether they can shop or cook on their own. These everyday activities turned out to be powerful predictors of future heart and brain problems.
The study found that two of the most important signs for future health were baseline cognition (how well a person thinks now) and baseline mobility (how well a person moves now). These two factors were better at predicting risk than many traditional markers.
Dr. Nanna hopes that this research encourages doctors to look beyond just the heart. He wants them to think about the whole person, especially when caring for older patients. Understanding a patient’s mental abilities and how independent they are can help guide better, more personal treatment choices.
Looking ahead, Dr. Nanna is also studying how heart medications might affect memory over time. Some common drugs used for chest pain or blood pressure might have effects on the brain, but this hasn’t been studied enough. His team has begun a new project to measure those effects.
He’s also working on a tool called “Consider, Listen, Decide,” to help older adults make smart choices about heart treatments. The goal is to give patients the information they need to make decisions that match their own values and goals.
In addition, Dr. Nanna recently started the HeartWise Lab with Dr. Abdulla Damluji to continue this work. Their team studies how heart disease and brain function connect, and how to treat both more effectively in older adults. They want treatments that don’t just extend life, but also protect independence and quality of life.
This research could be a big step toward more thoughtful and personal care for older adults—care that treats the heart and protects the brain at the same time.
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The study is published in the Journal of the American Heart Association.
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