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.

中文翻译：

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非卒中性心血管疾病状态对认知下降和痴呆风险的影响：系统和荟萃分析

心血管疾病与认知功能减退和痴呆的风险增加相关，但尚不清楚该风险是否随疾病状态而变化或是否在没有症状性中风的情况下发生。为了检查非中风性心血管疾病后认知下降和痴呆风险增加的证据，我们根据PRISMA指南进行了两次独立的荟萃分析。第一次审查了心血管疾病的诊断（房颤，充血性心力衰竭，周围动脉疾病和心肌梗塞），第二次审查评估了动脉粥样硬化负担的影响（狭窄程度，钙化评分，斑块形态或斑块数量所表明）。符合审查条件的研究纵向评估了临床上明显的认知能力下降和/或痴呆的风险，在基线时排除了中风和认知障碍。利用Cox比例危害数据（危害比，HR），通过逆方差加权方法计算汇总统计量。既有房颤（n  = 5，HR = 1.26，95％CI [1.12，1.43]）和严重动脉粥样硬化（n  = 4，HR = 1.59，95％CI [1.12，2.26]）已成为认知能力下降和/或痴呆的重要危险因素。 。一小部分研究进行了回顾，不足以进行荟萃分析，检查充血性心力衰竭，外周动脉疾病和心肌梗塞，提示这些情况也可能与认知能力下降/痴呆的风险增加有关。在没有中风的情况下，患有心房纤颤或全身性动脉粥样硬化的患者的认知能力下降风险更高。尽管如此，本文还是强调需要对CVD和痴呆之间的关系进行严格的方法和前瞻性研究。