Cognitive impairment and cardiovascular diseases in the elderly. A heart–brain continuum hypothesis

• Cardiovascular diseases affect the development of cognitive impairment in the elderly.
• Hypertension, coronary artery disease, atrial fibrillation and chronic heart failure are connected by a cardiovascular continuum.
• Thrombo-embolic and/or reduction of cardiac output appear to be the main mechanism.
• Interventional studies are necessary in order to prevent cognitive decline in patients with cardiovascular diseases.

The aging population is increasing and, therefore, a higher prevalence of cardiac disease is emerging; including hypertension, coronary artery disease, atrial fibrillation and chronic heart failure. Large cohort studies have revealed a relationship among increased risk for cognitive impairment and dementia in cardiovascular diseases probably due to embolic stroke or chronic cerebral hypoperfusion. Thus, the aim of the present review is to overview the studies that investigate the presence and/or the development of cognitive impairments and dementia in patients with varied types of cardiovascular disease. Finally, a continuum among hypertension, coronary artery disease, atrial fibrillation and chronic heart failure with to the development of cognitive impairment and progression to dementia has been hypothesized.