Atrial fibrillation and cognitive function in patients with heart failure: a systematic review and meta-analysis

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Pavlos G Myserlis1,2, Antonia Malli3,4, Dimitrios K Kalaitzoglou3,4

  • 1Society of Junior Doctors, Athens, Greece. pmyserlis@sni.gr.

Heart Failure Reviews
|November 16, 2016
PubMed

Insights

Atrial fibrillation (AF) significantly increases the risk of cognitive impairment in heart failure (HF) patients. Further research is needed to confirm this link and explore underlying mechanisms for potential interventions.

Area of Science:

  • Cardiology
  • Neurology
  • Geriatrics

Background:

  • Cognitive impairment and dementia are known complications of heart failure (HF).
  • Atrial fibrillation (AF) may independently contribute to cognitive decline in HF patients.
  • Medication adherence and self-care are negatively impacted by cognitive deficits in HF.

Purpose of the Study:

  • To systematically review and assess the effect of AF on cognitive function in patients with HF.
  • To synthesize evidence from primary research articles evaluating the AF-cognition relationship in HF.

Main Methods:

  • Systematic review of Medline (PubMed), Scopus, and CENTRAL databases up to April 30, 2016.
  • Inclusion of five primary research articles with 1670 HF patients (449 with AF).
  • Meta-analysis using inverse variance and random effects models to determine the odds ratio (OR) for cognitive impairment.

Main Results:

  • The presence of AF was significantly associated with an increased risk of cognitive impairment in HF patients (OR, 1.94; 95% CI, 1.30-2.87).
  • Significant heterogeneity (I² = 39%) was observed, attributed to variations in study populations, AF types, and cognitive assessment tools.
  • Four cognitive tests were utilized across the included studies.

Conclusions:

  • Concomitant AF may exacerbate cognitive dysfunction in patients with HF.
  • Current data are sparse and heterogeneous, necessitating well-designed, prospective studies.
  • Future research should aim to establish a causative link and identify mechanisms for targeted interventions.

Keywords:
Atrial fibrillationCognitive impairmentHeart failureMeta-analysisSystematic review

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