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Published on: February 26, 2013
Association between cognitive impairment and atrial fibrillation: a systematic review
1Department of Clinical and Surgical Sciences (Geriatric Medicine), The University of Edinburgh, Edinburgh, United Kingdom.
Insights
Atrial fibrillation (AF) is linked to stroke, but its connection to cognitive decline and dementia remains uncertain. More research is needed to confirm if AF causes cognitive impairment.
Area of Science:
- Neurology
- Cardiology
Background:
- Atrial fibrillation (AF) is a known cause of ischemic stroke.
- The association between AF and cognitive impairment is not well understood.
Purpose of the Study:
- To systematically review existing literature on the relationship between AF and cognitive impairment or dementia.
Main Methods:
- A comprehensive electronic search of multiple databases (Medline, Embase, Psychlit, Cinahl, Cochrane library) was conducted in March 2000.
- Included studies investigated the AF-cognition link, either as a primary aim or by reporting relevant data.
Main Results:
- Ten studies were identified (4 cross-sectional, 5 case-control, 1 prospective cohort).
- Methodological variations and flaws were present in all studies, precluding meta-analysis.
- Seven studies suggested an association between AF and cognitive measures, while three did not.
Conclusions:
- The current evidence linking AF to cognitive impairment is inconclusive.
- Further high-quality studies are necessary to establish a definitive relationship and its causal nature.
Purpose:
Although it is well established that atrial fibrillation (AF) causes ischemic stroke, the relationship between AF and cognitive impairment is unclear. The aim of this systematic review is to investigate whether AF is associated with cognitive impairment or dementia.
Materials And Methods:
An electronic search of Medline, Embase, Psychlit, Cinahl and the Cochrane library was performed in March 2000 to identify studies in which the primary aim was to investigate the relationship between AF and cognitive impairment or dementia. Studies with relevant data on both cognitive function and AF (even if that was not the primary aim of the study) were also identified. Further references were identified from these sources.
Results:
Ten studies were identified, of which 4 were cross-sectional, 5 were case-control, and 1 was a prospective cohort study. The methodology and measures of cognition varied substantially, so it was not valid to apply formal meta-analysis techniques to the results. However, the methodology in all the studies was flawed in at least 1 aspect, including the reporting of results, external validity, and internal validity. Seven studies found an association between AF and at least 1 measure of cognition whereas 3 studies did not find an association.
Conclusion:
The evidence that AF is associated with cognitive impairment is inconclusive. Further studies are required to establish whether there is a relationship between AF and cognitive impairment, and if so, whether the relationship is causal.
