Mental health, cardiovascular disease and dementia
How mood, the heart and cognition influence each other, and why it makes sense to assess them together.
Mental health, heart and brain
Mental health, heart health and cognition are more closely linked than they seem. They influence each other: a change in one of these areas can be reflected in the others.
Understanding these links helps to assess each situation better and to care for the person as a whole, rather than each organ separately.
Mental health and cardiovascular disease
Depression and anxiety are more common in people with cardiovascular disease, such as heart attack or heart failure. Conversely, depression is associated with a higher risk of cardiovascular disease and, in those who already have heart disease, with a worse outcome.1
Biological mechanisms such as inflammation and stress hormones contribute to this relationship, as do everyday factors: sleep, physical activity, smoking or difficulty keeping up with treatment. Recognising and treating depression is part of the overall care of people with cardiovascular disease.
Cognition and dementia
Difficulties with memory, attention or other cognitive abilities can have different causes and do not automatically mean dementia. Depression, anxiety, insufficient sleep, some medicines, vitamin deficiencies or thyroid disorders are among the possible causes, and many can be treated.
The same factors that harm the heart, such as high blood pressure, diabetes, smoking or a sedentary lifestyle, also increase the risk of cognitive decline and dementia. Depression is likewise considered a risk factor for dementia.2 When it appears for the first time later in life, it warrants careful assessment.
Learn more about cognitive difficulties and depression.
An integrated approach
An integrated assessment seeks to understand how mental health, physical health and cognition relate to each other in each person. Depending on the situation, it may involve:
- a detailed clinical history, including cardiovascular disease and risk factors;
- cognitive assessment during the consultation;
- a review of medication and possible interactions;
- blood tests;
- neuropsychological assessment;
- other tests, such as an electrocardiogram or brain imaging.
When useful, follow-up is coordinated with the GP, cardiology or neurology.
Research and academic career
From research to clinical practice
The relationship between mental health, cardiovascular disease and cognition was a central area of Pedro Zuzarte's PhD in Medicine at the Faculty of Medicine of the University of Lisbon, carried out in collaboration with the University of Toronto and Health Sciences North, in Canada.
This work studied NT-proBNP in patients with heart failure as a possible mediator between cardiac dysfunction and depressive symptoms, and reviewed the role of inflammation and oxidative stress as mechanisms shared by depression, cardiovascular disease and cognitive decline.
Related publications
2021 · Frontiers in Nutrition
Therapeutic opportunities for food supplements in neurodegenerative disease and depression
Neurodegenerative disease and depression
2018 · Journal of Psychiatric Research
NT-proBNP is a potential mediator between reduced ejection fraction and depression in patients with heart failure
Depression and heart failure
2018 · Current Drug Metabolism
Current therapeutic approaches for targeting inflammation in depression and cardiovascular disease
Inflammation, depression and cardiovascular disease
References
- Lichtman JH, et al. Depression as a risk factor for poor prognosis among patients with acute coronary syndrome: systematic review and recommendations. A scientific statement from the American Heart Association. Circulation. 2014;129(12):1350–1369.
- Livingston G, et al. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. Lancet. 2024;404(10452):572–628.
This page is for information only and does not replace an individual medical assessment. Clinical review: Pedro Zuzarte, psychiatrist · .
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