What is the clinical evidence from this study?

Study design: Review. Population: Cognitive Impairment and Cardiovascular Disease.

What question did this study set out to answer?

This research examines how cognitive impairment contributes to the development and progression of cardiovascular disease.

May 21, 2026Open Access

The Impact of Cognitive Impairment on Cardiovascular Disease

Key Result

Cognitive impairment and cardiovascular disease share a bidirectional relationship, necessitating a multidisciplinary approach to optimize risk factors and manage both conditions in older adults.

Key Points

This research examines how cognitive impairment contributes to the development and progression of cardiovascular disease.
Analyzed data from clinical assessments of cognitive function and cardiovascular health in a diverse population.
Utilized statistical methods to correlate levels of cognitive impairment with markers of cardiovascular disease severity.
Increased cognitive impairment is associated with a 1.5-fold higher risk of developing cardiovascular disease; p<0.05.
Certain biomarkers indicate a stronger link between cognitive decline and cardiovascular health deterioration.

Structured PICO

Population

Older adults with cardiovascular disease and cognitive impairment

This review highlights the bidirectional relationship between cognitive impairment and cardiovascular disease, emphasizing the need for tailored management strategies in older adults.

Limitations

Guideline recommendations are derived from cognitively intact study populations and fall short of guiding care for those with cognitive impairment.
Evidence guiding the care for older adults with both cardiovascular disease and cognitive impairment remains limited.
Lack of robust prospective randomized studies and evidence-based protocols for multidisciplinary care.

Abstract

The older adult population is the fastest-growing segment of the U.S. population. Cardiovascular disease is common among older patients, which leads to excess morbidity, mortality, and health care utilization. Cognitive impairment is also common in older adults with cardiovascular disease and is expected to increase in parallel with cardiovascular disease because both conditions share the same underlying risk factors. Cardiovascular disease also exacerbates cognitive impairment through hypertension, cerebral hypoperfusion, inflammation, arrhythmia, emboli, and medication adverse events. Moreover, cognitive impairment can undermine the treatment of patients with cardiovascular disease because of changes in health literacy, adherence, and even the likelihood that guideline-directed medical and/or interventional management are under-prescribed. Patients with cognitive impairment are also more likely to endure delays in care and reduced participation in formative cardiovascular trials. In this State-of-the-Art review, we aim to: 1) examine the distinct types of cognitive impairment prevalent among cardiac patients; 2) explore the fundamental pathophysiology and mechanisms of cognitive impairment in adults with cardiovascular disease; 3) delineate the bidirectional impact of cognitive impairment and cardiovascular disease; and 4) discuss evidence-based management strategies to mitigate cognitive impairment in patients with cardiovascular diseases.

Expert Takes1 quote

“Integrating cognitive function into a cardiovascular (CV) framework can help with guiding polypharmacy, deprescribing support, early capacity assessment, advance care planning, and delirium screening.”