Key result
Hypertrophic cardiomyopathy was associated with a 50% increased risk of incident dementia (HR 1.50) compared to propensity-matched controls.
Why the study?
Cardiac diseases contribute significantly to developing dementia, but the risk of dementia related to hypertrophic cardiomyopathy had never been evaluated.
Does hypertrophic cardiomyopathy increase the risk of incident dementia in adults aged ≥50 years?
Cohort (n=18,580)
Does hypertrophic cardiomyopathy increase the risk of incident dementia in adults aged ≥50 years?
Hazard Ratio: 1.5 (95% CI 1.27–1.78)
Absolute Event Rate: 5.2% vs 3.6%
p-value: p=<0.001
Hypertrophic cardiomyopathy is independently associated with a significantly increased risk of incident dementia, particularly Alzheimer's disease, suggesting a need for cognitive surveillance in this population.
HCM-associated dementia risk supports cognitive surveillance consideration; leaves open causal mechanisms and screening benefit.
BACKGROUND: Dementia is a big medical and socioeconomic problem on aging society, and cardiac diseases have already shown a significant contribution to developing dementia. However, the risk of dementia related to hypertrophic cardiomyopathy (HCM), the most common inherited cardiomyopathy, has never been evaluated. METHODS: In a large-scale longitudinal cohort using National Health Insurance database, 4,645 subjects with HCM aged ≥50 years between 2010 and 2016 were collected and matched with 13,935 controls, based on propensity scores (1:3). We investigated the incidence and risk of dementia, Alzheimer's disease (AD), and vascular dementia (VaD) between groups. RESULTS: During follow-up (median 3.9 years after 1-year lag), incident dementia occurred in 739 subjects (4.0%): 78.2% for AD and 13.0% for VaD. The incidence of dementia, AD, and VaD were 23.0, 18.0, and 2.9/1,000 person-years, respectively, and was generally more prevalent in HCM. HCM group had a 50% increased risk of dementia, particularly AD, whereas there was no difference in the risk of VaD. The impact of HCM on AD (HR 1.52, 95% CI 1.26-1.84, p<0.001) was comparable with that of diabetes mellitus and smoking. Increased risk of AD in relation to HCM was consistent in various subgroups including younger healthier population. CONCLUSIONS: This is the first to demonstrate the increased risk of dementia, mainly AD rather than VaD, in subjects with HCM. Early surveillance and active prevention for cognitive impairment could help for a better quality of life in an era that HCM is considered a chronic manageable disease with low mortality.
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Lee et al. (2022) conducted a cohort in Hypertrophic cardiomyopathy (n=18,580). Hypertrophic cardiomyopathy vs. Propensity score-matched non-HCM controls was evaluated on Incident dementia (HR 1.50, 95% CI 1.27-1.78, p=<0.001). Hypertrophic cardiomyopathy was associated with a 50% increased risk of incident dementia (HR 1.50) compared to propensity-matched controls.
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