February is famous for Valentine’s Day; the heart symbolizes love. When we are in love, we do not always use our brains to their full capacity (remember the old saying that “love is blind”). Also, in everyday life, most of us see the heart and the brain as being quite unrelated organs.

However, research proves that both organs are mutually dependent (interdependent) and have common risk factors, such as high blood pressure, high cholesterol, diabetes, obesity, sedentary lifestyle, etc. Cardiovascular diseases affect brain functioning, and mental illness usually causes stress that may affect heart health.

As a neuropsychologist, I frequently see stroke patients who usually have multiple cognitive problems, such as memory, attention/concentration, processing, speech/language, motor functions, or executive functioning problems. The cognitive outcomes of stroke can be variable. There are many risk factors, such as age, sex, stroke location, previous strokes, medical comorbidities, and mental health (depression).

However, research data indicate that heart failure, coronary heart disease (also called coronary artery disease or ischemic heart disease), microbleeds, and atrial fibrillation (irregular heartbeat) can cause microstructural changes in the brain. These changes may cause cognitive issues that may later in life result in dementia.

Heart failure reduces blood flow in the brain and can cause cognitive decline. Several studies have investigated cognitive problems in patients who experienced heart failure. The 2021 study (Jinawong, K. et al.) concluded that these patients experience memory loss as well as anxiety and depression. The other study (Festa J.R. et al. 2011) investigated memory functions in 207 older adults with heart failure and reduced ejection fraction (simply speaking, it measures how well the heart pumps blood).

The subjects were divided into two groups: those with an ejection fraction of 30% or higher and those with it below 30%. All subjects underwent a neuropsychological assessment. The results were interesting. Patients 63 years old and older with an ejection fraction below 30% had significant memory decline, especially in verbal delayed recall and recognition. However, patients younger than 63 had stable memory function no matter their ejection fraction.

Atrial fibrillation (irregular heartbeat), which causes poor blood flow, is another cardiovascular condition that can cause cognitive problems. The research data suggests that it is associated with a 39% increased risk of cognitive impairment (Koh, Y.H. et al., 2022).

An interesting study emerged from Spain (Mejia-Renteria, H. et al. 2023). The authors studied the cerebral-coronary connection in 67 patients (mean age 66 years, 73% female) with documented coronary artery disease. The patients underwent intracoronary physiological evaluation, brain magnetic resonance, and neurocognitive assessment, which showed significant cognitive impairments, mainly in attention and executive functions. The other study (Wolters, F.J. et al. 2018) indicated that coronary heart disease and heart failure are associated with an increased risk of dementia.

Researchers from the UK (Werring, D.J et al. 2004) examined the relationship between brain microbleeds and cognitive impairment. Microbleeds are usually clinically silent, but they are associated with hypertension, ischemic small vessel disease, and intracerebral hemorrhage. The subjects were 25 patients from the neurovascular clinic and 30 controls matched for age, gender, and level of intellectual functioning.

Both groups completed MRI and neuropsychological assessment. The results indicated that 60% of patients with microbleeds had problems with executive functioning compared to 30% of patients in the control group. The comprehensive 2017 study (Xuanting, Li. et al.) indicated that brain microbleeds are a risk factor for cognitive problems, especially attention, delayed recall, orientation, and calculation.

In summary, the research studies emphasize the importance of cardiovascular health as a predictor of cognitive functioning later in life. Therefore, starting a healthy lifestyle (healthy eating, exercising, and caring for our mental health) early in life is essential to avoid health issues later in life and possibly prevent dementia. Also, do not skip your yearly physical exams with your primary care physician, even if you feel okay, to ensure that your heart and other organs are still working healthily.

The research also suggests that mental health does affect our physical health. Therefore, if you suffer from depression or anxiety or have other mental health problems, it is essential to get professional help. Most therapists do telemedicine now, so you can get help in the comfort of your home. Good luck on the way to your best mental and physical health!