Atrial Fibrillation and Cognition: Epidemiological Data and Possible Mechanisms.

Abstract

Listen

Translate article

Dementia is one of the most disabling conditions in older people. Incidence of dementia steeply increases with age, doubling approximately every 5 years, and ranging from 4.0 per 1000 person-years in the group aged 65 to 69 years to 33.5 per 1000 person-years in the group aged 80 to 84 years.1 The most frequent type of dementia is Alzheimer’s disease (AD), followed by vascular dementia, a category encompassing different subtypes among which cerebral small vessel disease (SVD) and multi-infarct dementia are the most common.2 In both AD and vascular dementia, vascular risk factors play an important role, suggesting a possible favorable effect of treatment on the onset and progression of cognitive decline. Atrial fibrillation (AF) is a supraventricular tachyarrhythmia characterized by uncoordinated atrial activation and ineffective atrial contraction and may be detected on ECG when distinct P waves are absent, and R–R intervals and atrial activity are irregular.3 AF is the most common arrhythmia encountered in clinical practice, and, similarly to dementia, its prevalence increases with age. Approximately 1% of AF patients are 7 days).3 Interest has emerged concerning the possible role of AF in relation to cognitive decline and dementia. More than 40 years ago, the term cardiogenic dementia had been introduced in support of a possible link between cardiac arrhythmias and cognitive impairment in elderly subjects.4 Only recently the relation between AF and cognitive impairment has become the object of investigations, reviews, and meta-analyses.5–11 …