For nearly a decade, Jillianne Code’s heart wasn’t operating at capacity.
She had heart failure, meaning that her heart wasn’t pumping enough blood to meet her body’s needs — working at a tiny fraction of normal capacity when she was first hospitalized at 27 years old.
Although she’s since gone through two transplants, now the 42-year-old is worried that all those years of having a “sloppy and inefficient pump” in her chest have affected her brain.
They already have in dramatic fashion — twice. Blood clots in her heart moved to her brain, causing two strokes that temporarily left her unable to use her right arm.
But she suspects more subtle changes, too.
She has difficulty with concentration, forgets things and has to search for words at times, she said. “Yesterday I had to search for an hour to find my house keys, for example,” Code said. “And they were sitting on the table.”
As an assistant professor of education at the University of British Columbia, she worries about her ability to solve problems and handle complex conversations in graduate seminars.
“My whole job around being an academic relies on my ability to remember and my ability to pay attention.”
Vascular cognitive impairment
Heart and Stroke, in its annual research report, is highlighting the connection between the heart and the brain. If you have a heart condition, says the organization, your likelihood of developing cognitive impairment — of which dementia is a severe form — increases dramatically.
People with heart failure are 2.6 times more likely to develop vascular cognitive impairment — cognitive decline associated with changes to the blood vessels in the brain.
Congenital heart disease may triple the risk of developing vascular cognitive impairment before the age of 65. Heart conditions are also associated with a higher risk of stroke.
A stroke is a discrete event where a major blood vessel in the brain is blocked, leading to a “significant wedge” of the brain dying, said Dr. Dylan Blacquiere, a neurologist at the Ottawa Hospital.
But vascular cognitive impairment is a more gradual process, involving small vessels in the “white matter” which connects different parts of the brain. If those connections are blocked, he said, “then it’s much more difficult for the brain to talk to other parts of the brain and that can lead to that slowness of thinking.”
Some heart conditions may also affect how much oxygen gets to the brain, he said, and cause changes to it.
Code thinks that was happening before she had her first heart surgery and got a Left Ventricular Assist Device (LVAD) to help her heart pump. The difference was night and day, she said.
“My husband said to me, ‘It’s like I have my Jilly back. I have my wife back.’”
“Because I was alert and you know, I could remember things, I could do things,” Code said. “We could hold a conversation for longer than 30 seconds.”
In Code’s case, her heart failure led to stroke. People with a number of heart conditions, like heart valve disease, congenital heart disease and who have heart attacks are all at higher risk of stroke, according to Heart and Stroke.
That happened with Cheryl Beattie’s atrial fibrillation. She didn’t even know she had the condition until she had a stroke in her shower.
“Everything just went black and I didn’t realize I had had a stroke. I kept trying to go on with my routine,” she said. “I had shut the water off and was trying to put the shower head back. I couldn’t figure out how to do it.”
Her husband noticed how long she was taking in the bathroom and knocked on the door, she said.
“I answered him but he couldn’t understand what I was saying. I was slurring my words.”
At the hospital, doctors discovered her heartbeat was “all over the place.” She has no idea how long she had atrial fibrillation before it was diagnosed.
Since her stroke, she’s had trouble concentrating. “I don’t have any physical deficits. It’s just when I get tired or stressed out, my mind just shuts down. It doesn’t want to work.”
Heart and Stroke is warning that as the population ages and cardiovascular problems become more common, so too might cognitive decline.
“As we as a society age, the estimation is that this is going to skyrocket,” Blacquiere said.
Many heart conditions are appearing at earlier ages too, something that Heart and Stroke partly attributes to risk factors like poor diet and lack of physical activity.
Tackling those risk factors is a big part of helping to fix the problem, said Blacquiere. “So watching your blood pressure. Eating healthfully and getting regular exercise. Avoiding cigarette smoking and other risk factors that we’ve long known are associated with that.”
WATCH: A study shows any regular physical activity – even housework – reduces your chance of developing heart disease and an early death.
If you start noticing problems with your cognition, and especially if you or your family has a history of cardiovascular issues, you should speak to a health care provider, he said.
“When you have any kind of event with your heart, you should think also of some of the vascular implications and some longer-term things that may have happened as a result of that. And that includes your brain,” Code said.
“I believe that it’s catching up to me now.”