Cognitive Impairment and Functional Independence in Hospitalized Patients with Atrial Fibrillation: A Cross-Sectional...

Background/Objectives: Atrial fibrillation (AF) is associated with cognitive decline even without clinically apparent stroke, but the relative contributions of demographic, vascular, inflammatory and therapeutic factors remain unclear. We aimed to explore clinical determinants of cognitive and functional performance in hospitalized patients with AF. Methods: In this exploratory cross-sectional study, 62 consecutive patients with documented AF admitted to an internal medicine department underwent assessment with the Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE) and Activities of Daily Living (ADL) scale. Associations were examined with multivariable linear regression, with false-discovery-rate correction and sensitivity analyses. Results: Mean age was 75.3 ± 8.1 years; 17 patients (27.4%) had a previous ischemic stroke. Fifty-nine patients (95.2%) scored below the MoCA threshold of 26 and 35 (56.5%) below the MMSE threshold of 24. Patients with previous stroke scored lower on all three instruments (MoCA mean difference 4.13, 95% CI 0.75-7.51; MMSE 4.84, 1.67-8.01; ADL 1.69, 0.25-3.12). After correction for multiple testing, age remained associated with all three outcomes and previous stroke with MMSE score; no association was detected for sex, education, diabetes, C-reactive protein, LDL-cholesterol or anticoagulant type. Higher CHA₂DS₂-VAScscores were associated with poorer performance, though not independently of their own components. Conclusions: In this exploratory study, cognitive impairment was common among hospitalized patients with AF and was associated with age and previous stroke. These hypothesis-generating findings require confirmation in larger prospective studies.