Neuropsychology Review

, Volume 28, Issue 1, pp 1–15 | Cite as

The Effect of Non-Stroke Cardiovascular Disease States on Risk for Cognitive Decline and Dementia: A Systematic and Meta-Analytic Review

  • Kayla B. Stefanidis
  • Christopher D. Askew
  • Kim Greaves
  • Mathew J. SummersEmail author


Cardiovascular disease is associated with increased risk for cognitive decline and dementia, but it is unclear whether this risk varies across disease states or occurs in the absence of symptomatic stroke. To examine the evidence of increased risk for cognitive decline and dementia following non-stroke cardiovascular disease we conducted two independent meta-analyses in accordance with PRISMA guidelines. The first review examined cardiovascular diagnoses (atrial fibrillation, congestive heart failure, periphery artery disease and myocardial infarction) while the second review assessed the impact of atherosclerotic burden (as indicated by degree of stenosis, calcification score, plaque morphology or number of plaques). Studies eligible for review longitudinally assessed risk for clinically significant cognitive decline and/or dementia and excluded stroke and cognitive impairment at baseline. Summary statistics were computed via the inverse variance weighted method, utilising Cox Proportional Hazards data (Hazard Ratios, HR). Both atrial fibrillation (n = 5, HR = 1.26, 95% CI [1.12, 1.43]) and severe atherosclerosis (n = 4, HR = 1.59, 95% CI [1.12, 2.26]) emerged as significant risk factors for cognitive decline and/or dementia. A small set of studies reviewed, insufficient for meta-analysis, examining congestive heart failure, peripheral artery disease and myocardial infarction suggested that these conditions may also be associated with an increased risk of cognitive decline/dementia. In the absence of stroke, patients with atrial fibrillation or generalised atherosclerosis are at heightened risk for cognitive deterioration. Nonetheless, this paper highlights the need for methodologically rigorous and prospective investigation of the relationship between CVD and dementia.


Cardiovascular disease Dementia Cognitive decline Meta-analysis 


Author Contributions

KS: conceived and designed the research, performed statistical analyses, acquired the data, drafted the manuscript.

CA: made critical revisions of the manuscript for key intellectual content.

KG: made critical revisions of the manuscript for key intellectual content.

MS: conceived and designed the research, performed statistical analyses, acquired the data, drafted the manuscript.

Compliance with Ethical Standards


KS is a recipient of a University of the Sunshine Coast Postgraduate Research scholarship. MS reports personal fees from Eli Lily (Australia) Pty Ltd. and grants from Novotech Pty Ltd., outside the submitted work. All other authors report nothing to disclose.

Supplementary material

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Kayla B. Stefanidis
    • 1
  • Christopher D. Askew
    • 2
  • Kim Greaves
    • 3
  • Mathew J. Summers
    • 1
    Email author
  1. 1.Sunshine Coast Mind and Neuroscience - Thompson InstituteUniversity of the Sunshine CoastBirtinyaAustralia
  2. 2.School of Health & Sport SciencesUniversity of the Sunshine CoastSippy DownsAustralia
  3. 3.Sunshine Coast Health and Hospital Service, Nambour General Hospital, NambourUniversity of the Sunshine CoastSippy DownsAustralia

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