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Children born with heart defects have higher risk of premature dementia

Children with heart defects are more likely to develop heart disease risk factors

Ingrid Torjesen

Monday, 12 February 2018

Children born with heart defects who survive into adulthood may be at higher risk of developing dementia, particularly premature dementia, according to research* published in the American Heart Association's journal Circulation.

With improved newborn and childhood treatments, more people born with heart defects survive into adulthood.

Danish researchers used national medical databases and records covering all Danish hospitals to examine the occurrence of dementia in 10,632 mostly Caucasian adults (46% male) born with heart defects between 1890 and 1982 (most between 1960 and 1982). Each person with a heart defect was matched with 10 members of the general population of the same gender born the same year.

The researchers found the risk of dementia from any cause, including vascular dementia, Alzheimer's disease and others, in people born with heart defects in Denmark was 60% higher overall than the general population, 160% (2.6 times) higher for early-onset dementia (diagnosed before age 65), and 30% higher for dementia diagnosed after age 65.

Dementia or cognitive impairment can be caused by many factors, including reduced blood flow to the brain, strokes and Alzheimer's disease. In this study, the risk of dementia was higher in people born with heart defects who developed other heart disease risk factors later in life, such as atrial fibrillation, heart failure, and diabetes. These risk factors are more common in people born with heart defects than in the general population, and they have also been shown to independently raise the risk of dementia. In Denmark heart defects occur in eight to 10 out of every 1,000 live births.

Carina Bagge, lead author of the study and a medical student in the Department of Clinical Epidemiology at Aarhus University Hospital in Aarhus, Denmark, said: "Previous studies showed that people born with heart defects have a higher risk of neurodevelopmental problems in childhood, such as epilepsy and autism, but this is, to our knowledge, the first study to examine the potential for dementia later in adult life."

She added: "Our study involved an older population born when treatments for heart defects were more limited. Modern treatment has improved greatly, and as a result we can't directly generalise these results to children born today. We need further work to understand the risks in the modern era."

Senior author of the study Nicolas L Madsen, assistant professor of pediatrics at the Cincinnati Children's Hospital Medical Center, said: "Continued study of this association may yield important clinical screening and medical management strategies in the future, and there may even be opportunities discovered to aid in the prevention of dementia in this population."

*Bagge C, Henderson V, Laursen H, et al. Risk of Dementia in Adults With Congenital Heart Disease: Population-Based Cohort Study. Circulation. 2018;CIRCULATIONAHA.117.029686, originally published February 12, 2018.

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