心房細動と認知症:AF-SCREEN国際協力団体の報告書
Léna Rivard1, Leif Friberg2, David Conen3
1Montreal Heart Institute, Université de Montréal, Canada (L.R., P. Khairy).
Circulation
|January 31, 2022
まとめ
心房細動 (AF) は脳卒中とは無関係に認知機能低下と認知症に関連しています. AF患者における因果関係を確認し,脳健康のための予防戦略を探求するには,さらなる研究が必要である.
科学分野:
- 心臓病科
- 神経学
- 高齢者医療
背景:
- 心房細動 (AF) と認知障害や認知症との関連が 明らかになってきています
- この関連性は,臨床脳卒中と共通のリスク要因とは無関係である.
- AF-SCREEN国際協力は,この証拠の包括的なレビューを提供します.
研究 の 目的:
- 認知障害と認知症を 関連付ける証拠をまとめます
- AF患者における認知症の調査と管理に関するガイドラインを提供すること.
- 病理生理学的メカニズムに対処し,研究のギャップを特定する.
主な方法:
- AFと認知障害に関する既存の証拠の体系的なレビューと合成.
- AFと認知症を結びつける病理学的メカニズムの分析
- 知識のギャップと将来の研究分野を特定する.
主要な成果:
- AFと認知障害/認知症との関連は,脳卒中とは関係なく一貫して報告されています.
- 潜在的メカニズムには,脳内小心筋梗塞,低血流,炎症,微小出血が含まれています.
- AFの因果的な役割と,抗凝固薬のような介入の有効性は,まだ定かではありません.
結論:
- AFと認知症の危険因子は同じですが 直接的な因果関係についてはさらなる調査が必要です
- 潜在的病理生理学的経路は早期介入の標的となる.
- 原因と予防戦略と認知健康における AFスクリーニングの役割を確立するために大規模な研究が必要です.
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