New thesis on Cardiovascular disease in dementia
Hi Pavla Cermakova, you recently defended your thesis "Cardiovascular disease in dementia" at the Division of Neurogeriatrics..
What´s the main focus of your research?
"My thesis concerns cardiovascular disease in patients with several dementia disorders – Alzheimer´s disease, mixed dementia, vascular dementia, frontotemporal dementia, dementia with Lewy bodies and Parkinson´s disease dementia. Our aim was to study which cardiovascular diseases the patients with dementia suffer from, how they are treated and whether the treatment helps them to survive longer. In particular we emphasized on heart failure and heart attack. Further, we aimed to explore whether heart diseases as soon as in young adulthood can already affect the aging brain".
Which are the most important results?
- Seventy percent of patients with dementia are prescribed cardiovascular drugs. Their use is highest in patients with vascular dementia and lowest in patients with Parkinson´s disease dementia.
- In patients with heart failure and dementia, heart failure with preserved ejection fraction is the most common type of heart failure and vascular dementia the most frequent dementia disorder.
- The most common chronic cardiovascular disease in patients with dementia is ischemic heart disease (23% of patients are affected), followed by cerebrovascular diseases (20% of patients) and atrial fibrillation (19% of patients).
- Twenty one per cent of patients with dementia are managed invasively for acute myocardial infarction. The use of invasive procedures is associated with lower age and higher cognitive status. This study suggests that the invasive management of myocardial infarction has a benefit for survival of patients with dementia.
- Higher left atrial volume in the heart in young adults is associated with lower white matter integrity in their brain in mid-life. This study suggests that improvement of cardiac function in young adults may benefit the aging brain.
How can this new knowledge contribute to the improvement of people’s health?
"We are still far from making a firm conclusion and a clear message to the clinic. But we propose that the invasive management of myocardial infarction (using coronary angiography and percutaneous coronary intervention) has a benefit for survival of patients with dementia, thus it should be used in them. Further, we suggest that preventing heart disease in young adults could protect their brain health".
What´s in the future for you? Will you keep on conducting research?
"I am starting a postdoc at the Institute of Neuroscience at Trinity College in Dublin, Ireland. I am going to continue with research, but I am moving away from observational studies to interventions".