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Atrial Fibrillation, Brain Structure and Cognitive Function: A Mediation Analysis.

Jung-Ho Yang1,2, Sun-Seog Kweon2, Yu-Mi Kim3

  • 1Regional Cardiocerebrovascular Center, Chonnam National University Hospital, Gwangju, Korea.

Korean Circulation Journal
|January 21, 2026
PubMed
Summary
This summary is machine-generated.

Atrial fibrillation (AF) is linked to brain atrophy and cognitive decline. Brain structure partially mediates this AF-cognition relationship, highlighting the need for integrated care.

Keywords:
Atrial fibrillationBrainCognitionCohort studiesMediation analysis

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Area of Science:

  • Neuroscience
  • Cardiology
  • Gerontology

Background:

  • Atrial fibrillation (AF) increases risks for cerebrovascular disease and cognitive impairment.
  • Limited evidence exists on brain structural changes mediating the AF-cognition link, particularly in Asian populations.

Purpose of the Study:

  • Investigate associations between AF, MRI-measured brain structures, and cognitive function.
  • Evaluate the mediating role of brain structural changes in the AF-cognition relationship.

Main Methods:

  • Analyzed 2,662 participants from the KoGES-CAVAS-C cohort without prior stroke or missing data.
  • Identified AF via ECG, assessed cognition using the Seoul Neuropsychological Screening Battery-Core.
  • Measured brain volumes and white matter integrity using MRI; performed regression and mediation analyses.

Main Results:

  • 50 participants (1.9%) had AF; they exhibited lower total brain volume and reduced regional volumes.
  • The AF group showed poorer overall cognitive function, including memory and executive function.
  • AF was associated with lower total brain volume (p=0.005) and cognitive scores (p=0.037).
  • Total brain volume partially mediated the AF-cognition association (p=0.007), explaining 11% of the effect.

Conclusions:

  • Atrial fibrillation is associated with brain atrophy and cognitive impairment.
  • Brain structure partially mediates the relationship between AF and cognitive function.
  • Integrated cardiovascular and cognitive assessments are recommended for AF management.