Thursday, March 11, 2021

Cardiovascular Problems May Worsen Cognition in People With Schizophrenia

Risk factors for cardiovascular disease (CVD), such as metabolic disorders, diabetes, or hypertension, are significantly associated with cognitive deficits in patients with schizophrenia, according to a study published in JAMA Psychiatry.

The findings point to the importance of efforts to address risk factors for cardiovascular disease in these patients to help prevent further deterioration in cognition and improve functioning, wrote Katsuhiko Hagi, Ph.D., of Sumitomo Dainippon Pharma in Tokyo, Japan, Jean Pierre Lindenmayer, M.D., of the New York University School of Medicine, and colleagues.

Hagi and colleagues searched databases including Embase, Scopus, MEDLINE, PubMed, and Cochrane for studies on cognitive functioning in patients with schizophrenia or schizoaffective disorder and the association of CVD risk factors (including metabolic syndrome, diabetes, obesity, hypertension, and others). The studies also compared cognitive performance between those with and without CVD risk factors.

In total, 27 studies were included in the analysis, representing 10,174 individuals with schizophrenia. The authors identified significantly greater cognitive deficits in patients who had metabolic disorders, diabetes, or hypertension compared with those who did not have those disorders. Further, these patients performed worse on reasoning/problem solving, speed of processing, and verbal learning compared with patients without these disorders. Cognitive impairment was not significantly associated with being overweight or obese.

The authors noted that pharmacological interventions and other lifestyle changes, such as diet, for cardiovascular risk factors are treatment options for individuals with schizophrenia. However, they added, implementing such interventions can be challenging since people with schizophrenia have such low rates of access to care.

“Routine physical health monitoring and interventions to improve physical health in people with schizophrenia are urgently needed to maintain or restore physical and mental health and improve functional outcomes,” Hagi and colleagues wrote. “Collaborative care models that integrate behavioral and medical care are likely to be particularly useful for addressing CVD risk in those with schizophrenia.”

For related information, see the Psychiatric News article “Cardioprotective Treatments After Heart Attack Can Help Patients With Schizophrenia Live Longer.”

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