Heart failure and risk of dementia: a Danish nationwide population-based cohort study.
The association between heart failure and dementia remains unclear. We assessed the risk of dementia among patients with heart failure and members of a general population comparison cohort.



Individual-level data from Danish medical registries were linked in this nationwide population-based cohort study comparing patients with a first-time hospitalization for heart failure between 1980 and 2012 and a year of birth-, sex-, and calendar year-matched comparison cohort from the general population. Stratified Cox regression analysis was used to compute 1-35-year hazard ratios (HRs) for the risk of all-cause dementia and, secondarily, Alzheimer's disease, vascular dementia, and other dementias. Analyses included 324 418 heart failure patients and 1 622 079 individuals from the general population (median age 77 years, 52% male). Compared with the general population cohort, risk of all-cause dementia was increased among heart failure patients [adjusted HR 1.21, 95% confidence interval (CI) 1.18-1.24]. The associations were stronger in men and in heart failure patients under age 70. Heart failure patients had higher risks of vascular dementia (adjusted HR 1.49, 95% CI 1.40-1.59) and other dementias (adjusted HR 1.30, 95% CI 1.26-1.34) than members of the general population cohort. Heart failure was not associated with Alzheimer's disease (adjusted HR 1.00, 95% CI 0.96-1.04).



Heart failure was associated with an increased risk of all-cause dementia. Heart failure may represent a risk factor for dementia, but not necessarily for Alzheimer's disease.
Department of Clinical Epidemiology, Aarhus University Hospital, Skejby, Aarhus, Denmark.
Kasper
K
Adelborg
Department of Clinical Epidemiology, Aarhus University Hospital, Skejby, Aarhus, Denmark.
Erzsébet
E
Horváth-Puhó
Department of Clinical Epidemiology, Aarhus University Hospital, Skejby, Aarhus, Denmark.
Anne
A
Ording
Department of Clinical Epidemiology, Aarhus University Hospital, Skejby, Aarhus, Denmark.
Lars
L
Pedersen
Department of Clinical Epidemiology, Aarhus University Hospital, Skejby, Aarhus, Denmark.|Departments of Health Research and Policy (Epidemiology) and of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA.
Henrik Toft
HT
Sørensen
Department of Clinical Epidemiology, Aarhus University Hospital, Skejby, Aarhus, Denmark.|Departments of Health Research and Policy (Epidemiology) and of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA.
Victor W
VW
Henderson
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology*; D015331:Cohort Studies; D003704:Dementia / Q000453:epidemiology; D015140:Dementia, Vascular / Q000453:epidemiology*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000453:epidemiology*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012042:Registries; D012306:Risk; D012307:Risk Factors; D012737:Sex Factors
Dementia; Epidemiology; Heart failure; Morbidity