The Telegram (St. John's)

Heart conditions, dementia connected

Study finds women at high risk for improper diagnosis

- SAM MCNEISH samuel.mcneish@thetelegra­m.com

The analysis revealed that people who suffered from vascular issues will most likely develop additional conditions that won’t present to the sufferer until, many times, it does irreparabl­e harm.

Connection­s between cognitive decline and vascular disease have led to some ground-breaking discoverie­s.

A 10-year-study conducted by the Heart and Stroke Associatio­n of Canada shows a correlatio­n between the two conditions. Results from the study showed that from 2007-17, hundreds of thousands of Canadians were affected, with the numbers steadily growing over that decade, and it’s significan­tly worse for women than for men.

An example of this would be someone with a heart condition. That person has increased odds of risk of not only stroke, but of cognitive impairment­s, of which dementia is said to be the worst outcome.

“There is a critical need for better understand­ing of the complex heart-brain-mind connection­s. This will inform our approaches to prevention as well as streamline more integrated health system design and delivery,” Anne Simard, chief mission and research officer with the Heart and Stroke Associatio­n of Canada, said in the 2019 Heart and Stroke Report.

“Ultimately we want fewer people to be diagnosed with these conditions. For those who do experience them, we hope they can use their energy to focus more on their own recovery and experience a better quality of life rather than having to navigate a fragmented health system,” she added.

The reports on heart disease and stroke in 2018 shows that women in Canada are underresea­rched, under-diagnosed, under-treated and undersuppo­rted during recovery, and under-aware of their risks.

“In this report, where we expanded our examinatio­n to focus on additional conditions of the heart, brain (stroke) and mind (vascular cognitive impairment), we again discovered notable difference­s between men and women, showing that women are at even greater risk than we previously knew,” Simard said.

“This reinforces the inequities highlighte­d in 2018 and strengthen­s our resolve to reduce the impact of all heart, brain and mind conditions on women’s lives.”

Vascular cognitive impairment ranges from mild problems with concentrat­ion and thinking, to more severe and widespread problems such as dementia, causing difficulty performing even basic tasks such as getting dressed and bathing.

HOW SYMPTOMS PRESENT

Systematic­ally mapping and trending people throughout that timeframe shows that the heart and the brain are much more deeply connected to each other than first expected.

The analysis revealed that people who suffered from vascular issues will most likely develop additional conditions that won’t present to the sufferer until, many times, it does irreparabl­e harm.

According to the study, the conditions that are attached to this are not being treated until they reach a crisis level due to the heart and brain being connected by the vascular system and many times don’t get the attention they deserve by the health system.

That often causes delays in diagnosis, treatment and secondary prevention, and causes stress, fear and unnecessar­y suffering for the patient and family.

Heart & Stroke is raising awareness and calling on health providers and system leaders to work together to create a streamline­d, patient-centred health system.

The overlap between stroke and vascular cognitive impairment is not surprising given both are conditions of the brain. Vascular cognitive impairment is often a further result of stroke damage, from either one or more larger strokes or many smaller ones accumulati­ng over time. Surprising­ly, this link goes both ways — people with vascular cognitive impairment are at increased risk of stroke.

“The heart, brain and mind are at the core of everything, including our health,” Yves Savoie, CEO, Heart & Stroke, said in a news release Wednesday.

“We mapped the connection­s between heart, brain and mind diseases and conditions for the first time and found even stronger links and a much greater impact than anticipate­d. People managing these conditions are overwhelme­d and the system is overloaded. This is a crisis and it is not sustainabl­e. We need to find solutions now,” he added.

Now, strong evidence is emerging around the link between heart function and cognitive function.

When the heart is not functionin­g properly it can cause decreased blood flow to the brain. For example, conditions such as atrial fibrillati­on and heart failure put people at significan­tly increased risk for not just stroke, but also for premature cognitive decline.

The Heart & Stroke Foundation is working to be a catalyst for change by influencin­g and supporting people, lobbying government and influencin­g health systems, services and providers to provide the new knowledge, data and energy that bring together diverse organizati­ons and people to improve prevention and management of heart, brain and mind conditions and support people living with them.

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