Introduction of At the Heart of Brain Disorders – Preventing Cognitive Decline and Dementia

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Heart-brain interaction is an indisputable fact. The connection between vascular risk factors and/or cardiovascular disease and cognitive impairment and dementia has been supported by countless publications in the past 30 years. The most important studies concluded that vascular brain injury exacerbates cognitive ageing, and increases the risk for dementia both in its vascular type and in its degenerative type (Alzheimer’s disease). However, the negative impact of vascular risk factors depends on, first, the length of exposure to vascular injury, and second, the burden of vascular injury accumulated over time.

This connection, complex in essence, is actually an inverse problem because the aim is to identify the past circumstances that have led to heart and/or brain disease. A myriad of strategies for controlling the problem may arise from the interpretation of the facts and the plausible associations derived from scientific observation.

Over the past 50 years, vascular medicine – based on major technological developments – has significantly extended lifespan, but has failed to put forth prevention strategies to reduce heart and cerebrovascular morbimortality. Timely intervention on modifiable vascular risk factors might diminish the prevalence of both cardiovascular and neurocognitive diseases, and place prevention at the core of the matter. A deep understanding of the heart-brain interaction will enable the implementation of health policies that ensure normal brain ageing, and thus longer preservation of intellectual capacity and autonomy. This review intends to discuss this heart-brain connection, describe how uncontrolled vascular disease impacts on cognition, and emphasise the importance of prevention and health promotion messages.

This review is based on bibliographic consultations in: MEDLINE, SciELO, EMBASE, LILACS, and other data sources. The terms employed for the search were: cognitive impairment, dementia, Alzheimer’s disease, vascular risk factors, and cardiovascular prevention. Bibliography from the past 10 years was examined including review studies, original research papers, population-based epidemiological studies, and intervention studies.

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