{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T23:16:20Z","timestamp":1788218180843,"version":"build-2803163510"},"reference-count":278,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T00:00:00Z","timestamp":1692576000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National University of Singapore Yong Loo Lin School","award":["NMRC\/MOH-001080"],"award-info":[{"award-number":["NMRC\/MOH-001080"]}]},{"name":"National University of Singapore Yong Loo Lin School","award":["NMRC\/TA23jan-0009"],"award-info":[{"award-number":["NMRC\/TA23jan-0009"]}]},{"DOI":"10.13039\/501100001349","name":"Singapore Ministry of Health\u2019s National Medical Research Council","doi-asserted-by":"publisher","award":["NMRC\/MOH-001080"],"award-info":[{"award-number":["NMRC\/MOH-001080"]}],"id":[{"id":"10.13039\/501100001349","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001349","name":"Singapore Ministry of Health\u2019s National Medical Research Council","doi-asserted-by":"publisher","award":["NMRC\/TA23jan-0009"],"award-info":[{"award-number":["NMRC\/TA23jan-0009"]}],"id":[{"id":"10.13039\/501100001349","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biology"],"abstract":"<jats:p>Cognitive impairment (CI) shares common cardiovascular risk factors with acute myocardial infarction (AMI), and is increasingly prevalent in our ageing population. Whilst AMI is associated with increased rates of CI, CI remains underreported and infrequently identified in patients with AMI. In this review, we discuss the evidence surrounding AMI and its links to dementia and CI, including pathophysiology, risk factors, management and interventions. Vascular dysregulation plays a major role in CI, with atherosclerosis, platelet activation, microinfarcts and perivascular inflammation resulting in neurovascular unit dysfunction, disordered homeostasis and a dysfunctional neurohormonal response. This subsequently affects perfusion pressure, resulting in enlarged periventricular spaces and hippocampal sclerosis. The increased platelet activation seen in coronary artery disease (CAD) can also result in inflammation and amyloid-\u03b2 protein deposition which is associated with Alzheimer\u2019s Dementia. Post-AMI, reduced blood pressure and reduced left ventricular ejection fraction can cause chronic cerebral hypoperfusion, cerebral infarction and failure of normal circulatory autoregulatory mechanisms. Patients who undergo coronary revascularization (percutaneous coronary intervention or bypass surgery) are at increased risk for post-procedure cognitive impairment, though whether this is related to the intervention itself or underlying cardiovascular risk factors is debated. Mortality rates are higher in dementia patients with AMI, and post-AMI CI is more prevalent in the elderly and in patients with post-AMI heart failure. Medical management (antiplatelet, statin, renin-angiotensin system inhibitors, cardiac rehabilitation) can reduce the risk of post-AMI CI; however, beta-blockers may be associated with functional decline in patients with existing CI. The early identification of those with dementia or CI who present with AMI is important, as subsequent tailoring of management strategies can potentially improve outcomes as well as guide prognosis.<\/jats:p>","DOI":"10.3390\/biology12081154","type":"journal-article","created":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T00:46:22Z","timestamp":1692665182000},"page":"1154","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Acute Myocardial Infarction and Risk of Cognitive Impairment and Dementia: A Review"],"prefix":"10.3390","volume":"12","author":[{"given":"Elizabeth Hui En","family":"Thong","sequence":"first","affiliation":[{"name":"Internal Medicine Residency, National University Health System, Singapore 119074, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2417-7045","authenticated-orcid":false,"given":"Ethan J. W.","family":"Quek","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing Hong","family":"Loo","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Choi-Ying","family":"Yun","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National University Heart Centre Singapore, Singapore 119074, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1150-9174","authenticated-orcid":false,"given":"Yao Neng","family":"Teo","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0439-4097","authenticated-orcid":false,"given":"Yao Hao","family":"Teo","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency, National University Health System, Singapore 119074, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aloysius S. T.","family":"Leow","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency, National University Health System, Singapore 119074, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tony Y. W.","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National University Heart Centre Singapore, Singapore 119074, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8976-5696","authenticated-orcid":false,"given":"Vijay K.","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore"},{"name":"Division of Neurology, Department of Medicine, National University Hospital, Singapore 119074, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1824-9077","authenticated-orcid":false,"given":"Benjamin Y. Q.","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore"},{"name":"Division of Neurology, Department of Medicine, National University Hospital, Singapore 119074, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard L. L.","family":"Yeo","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore"},{"name":"Division of Neurology, Department of Medicine, National University Hospital, Singapore 119074, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao Feng","family":"Chong","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine, National University Hospital, Singapore 119074, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark Y.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore"},{"name":"Department of Cardiology, National University Heart Centre Singapore, Singapore 119074, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2764-2869","authenticated-orcid":false,"given":"Ching-Hui","family":"Sia","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore"},{"name":"Department of Cardiology, National University Heart Centre Singapore, Singapore 119074, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,21]]},"reference":[{"key":"ref_1","first-page":"116","article-title":"Myocardial infarction in the elderly","volume":"2","author":"Carro","year":"2011","journal-title":"Aging Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e94","DOI":"10.1016\/S2468-2667(21)00277-2","article-title":"Forecasting the prevalence of dementia","volume":"7","author":"Schwarzinger","year":"2022","journal-title":"Lancet Public Health"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1056\/NEJM199608013350507","article-title":"Evaluation of Dementia","volume":"335","author":"Geldmacher","year":"1996","journal-title":"N. 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