Is There an Increased Risk of Dementia After Surviving a Myocardial Infarction?
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Article, see p 567
To survive a myocardial infarction but then face the potential for the development of dementia is unsettling to say the least. In a study in this issue of Circulation, Sundbøll and colleagues1 test this association in a Danish nationwide patient registry. Administrative records are used to track incident dementia over ≤35 years of follow-up for 314 911 one-year survivors of myocardial infarction (MI) and 1 573 193 controls without MI. Although all-cause dementia did not differ between the groups over the follow-up period, vascular dementia was more frequent in individuals with an MI, particularly in those with a stroke during follow-up or who required coronary artery bypass grafting (CABG) surgery.
When interpreting what these results mean for the survivor of an MI, however, it is important to consider how these conditions were defined and what the likely explanation might be for the observed associations. In this study, individuals with MI and without MI were clearly 2 different groups of individuals: although matched to the MI cases for sex, birth year, and calendar year, it is not surprising that those people without an MI had lower vascular risk with higher levels of educational attainment and socioeconomic status than did their counterparts who did experience an MI. Although attempts were made to adjust for these observed differences, it is likely that these groups remain substantively different.
As a result of these differences, it remains unclear whether the increased risk is because of the MI or the underlying risk that led to the MI in …