Cognitive Impairment in Atrial Fibrillation Patients: A Literature Review

Abstract

Introduction: Atrial fibrillation (AF) has become one of the most significant health problems worldwide, warranting urgent answers to currently pending questions on the effects of AF on brain function. Recent evidence has emerged to show an association between AF and an increased risk of developing dementia and worsening of stroke outcomes. In the last two decades several reports have shown an association between AF and cognitive function, ranging from impairment to dementia. Purpose: To present data on cognitive impairment in atrial fibrillation patients. Materials and methods: The study material consisted of reviewed articles on the topic found on the globally accepted electronic databases, PubMed, Medline, Google Scholar, regarding cognitive decline in atrial fibrillation patients. The study material consisted of scientific books, reviews and research papers published online. Results: In the absence of clinical stroke, people with incident atrial fibrillation are likely to reach thresholds of cognitive impairment or dementia at earlier ages than people with no history of atrial fibrillation. Results in a large sample of patients show that AF may be associated with higher risk for both cognitive impairment and dementia in patients with preexisting stroke, even if there was significant heterogeneity in the analysis for cognitive impairment. Adequate oral anticoagulation and improved management of the overall cardiovascular risk profile in individuals with AF offer the promise of reducing the impact of AF on cognitive decline and dementia. Conclusion: AF is associated with higher risk of developing AD and dementia. Future studies should examine whether specific treatments, including optimal anticoagulation, can decrease this risk.