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Atrial fibrillation and cognitive decline: a longitudinal cohort study
Evan L Thacker1, Barbara McKnight, Bruce M Psaty
1Cardiovascular Health Research Unit, Department of Epidemiology, University of Washington, Seattle, WA, USA. elt@uab.edu
Neurology
|June 7, 2013
Summary
People with atrial fibrillation experience faster cognitive decline, even without clinical stroke. This condition may lead to earlier onset of cognitive impairment or dementia.
Area of Science:
- Neurology
- Cardiology
- Gerontology
Background:
- Atrial fibrillation is a common cardiac arrhythmia.
- Cognitive decline is a significant concern in aging populations.
- The relationship between atrial fibrillation and cognitive decline, independent of stroke, requires further investigation.
Purpose of the Study:
- To investigate the association between incident atrial fibrillation and the rate of cognitive decline.
- To determine if atrial fibrillation accelerates cognitive decline in the absence of clinical stroke.
Main Methods:
- Longitudinal analysis of 5,150 participants aged 65+ from the Cardiovascular Health Study.
- Exclusion of participants with baseline atrial fibrillation or prior stroke.
- Assessment of cognitive decline using the Modified Mini-Mental State Examination (3MSE) annually.
Main Results:
- Incident atrial fibrillation was identified in 10.7% of participants over a mean follow-up of 7 years.
- Cognitive decline, measured by 3MSE scores, was significantly faster in individuals who developed atrial fibrillation.
- Participants with incident atrial fibrillation at age 80 showed a predicted 5-year decline of -10.3 points compared to -6.4 points in those without atrial fibrillation.
Conclusions:
- Incident atrial fibrillation is associated with accelerated cognitive decline, even without overt stroke.
- Individuals with atrial fibrillation may reach cognitive impairment or dementia thresholds at earlier ages.
- Findings highlight the importance of managing atrial fibrillation to potentially preserve cognitive function.
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