Heart failure and risk of dementia: a Danish nationwide population‐based cohort study

Aims The association between heart failure and dementia remains unclear. We assessed the risk of dementia among patients with heart failure and members of a general population comparison cohort. Methods and results Individual‐level data from Danish medical registries were linked in this nationwide population‐based cohort study comparing patients with a first‐time hospitalization for heart failure between 1980 and 2012 and a year of birth‐, sex‐, and calendar year‐matched comparison cohort from the general population. Stratified Cox regression analysis was used to compute 1–35‐year hazard ratios ( HRs ) for the risk of all‐cause dementia and, secondarily, Alzheimer's disease, vascular dementia, and other dementias. Analyses included 324 418 heart failure patients and 1 622 079 individuals from the general population (median age 77 years, 52% male). Compared with the general population cohort, risk of all‐cause dementia was increased among heart failure patients [adjusted HR 1.21, 95% confidence interval ( CI ) 1.18–1.24]. The associations were stronger in men and in heart failure patients under age 70. Heart failure patients had higher risks of vascular dementia (adjusted HR 1.49, 95% CI 1.40–1.59) and other dementias (adjusted HR 1.30, 95% CI 1.26–1.34) than members of the general population cohort. Heart failure was not associated with Alzheimer's disease (adjusted HR 1.00, 95% CI 0.96–1.04). Conclusion Heart failure was associated with an increased risk of all‐cause dementia. Heart failure may represent a risk factor for dementia, but not necessarily for Alzheimer's disease.