Help Your Heart, Save Your Brain

Heart attack prevention measures may also help preserve memory for patients with Alzheimer’s and dementia

Kenneth Langa Photo: Martin Vloet

Medications and lifestyle changes that help prevent a heart attack or stroke could also prevent or slow the memory loss and confusion of dementia, according to U-M researchers. For some people with a condition called mixed dementia, controlling blood pressure and cholesterol could help more than memory-preserving drugs.

Mixed dementia is a combination of Alzheimer’s disease and vascular dementia, caused in part by problems with blood flow in the brain. It may affect as many as 20 percent of the 6.8 million Americans with dementia. Doctors now think that many people with symptoms attributed solely to Alzheimer’s — memory loss, confusion, wandering, trouble following instructions — may have mixed dementia.

“The effects of high blood pressure and high cholesterol damage small blood vessels in the brain and can cause death of brain cells over time,” says Kenneth Langa, M.D., Ph.D. (Residency 1997), an assistant professor of internal medicine and assistant research scientist in the Institute of Gerontology.

“In addition, the Alzheimer’s disease process itself can affect the walls of blood vessels in the brain, making strokes more likely,” Langa says. “Strokes can cause dementia through the death of large areas of brain tissue, or through the build-up of damage from multiple small strokes caused by atherosclerosis in small arteries in the brain or the larger carotid arteries in the neck.”

Langa and the research team reviewed all recent studies on mixed dementia, vascular dementia and Alzheimer’s. They analyzed hundreds of articles, noting any results from drug studies that were relevant to mixed dementia. The researchers concluded that efforts to treat cardiovascular risk factors, especially high blood pressure, may be more effective than memory drugs in protecting brain function.

—KG

Read an expanded version of the story:
www.med.umich.edu/opm/newspage/2004/mixeddementia.htm

For patient information on Alzheimer’s disease and dementia:
www.med.umich.edu/1libr/aha/aha_alzhdis_crs.htm