Atrial Fibrillation Is Associated With Lower Cognitive Performance in the Framingham Offspring Men

Elias, Merrill F.; Sullivan, Lisa M.; Elias, Penelope K.; Vasan, Ramachandran S.; D’Agostino, Ralph B.; Seshadri, Sudha; Au, Rhoda; Wolf, Philip A.; Benjamin, Emelia J.

doi:10.1016/j.jstrokecerebrovasdis.2006.05.009

Cited by 72 publications

(42 citation statements)

References 43 publications

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“…In the current study, we used exclusively the MMSE and MST for evaluation, although many kinds of assessment can be applied, as has been done in the Framingham Study. 16 The use of a broader test would have produced a more in-depth evaluation of the neuropsychological characteristics of VCI in the general population. In particular, loss of motivation or apathy frequently mimics frontal lobe dysfunction and should be evaluated by other means such as apathy scale 17 in future studies.…”

Section: Discussionmentioning

confidence: 99%

Cognitive Consequences of Multiple Lacunes and Leukoaraiosis as Vascular Cognitive Impairment in Community-Dwelling Elderly Individuals

Koga

Takashima

Ryo

et al. 2009

Journal of Stroke and Cerebrovascular Diseases

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Section: Discussionmentioning

confidence: 99%

Cognitive Consequences of Multiple Lacunes and Leukoaraiosis as Vascular Cognitive Impairment in Community-Dwelling Elderly Individuals

Koga

Takashima

Ryo

et al. 2009

Journal of Stroke and Cerebrovascular Diseases

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“…[137][138][139] Although shared risk factors have been proposed as a potential mechanism, the association between AF and cognitive impairment persists after risk factor adjustment. 140,141 In a meta-analysis including 77 668 patients, of whom 11 700 had AF, AF was associated with a 42% greater risk of dementia after adjustment for other known stroke-promoting conditions. 142 Hypothesized pathophysiological mechanisms include cerebral hypoperfusion, 143 microembolization, 144 inflammation, and platelet dysfunction.…”

Section: Cognitive Dysfunctionmentioning

confidence: 99%

The Clinical Profile and Pathophysiology of Atrial Fibrillation

Andrade

Khairy

Dobrev

et al. 2014

Circulation Research

982

364

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Atrial fibrillation (AF) is the most common arrhythmia (estimated lifetime risk, 22%–26%). The aim of this article is to review the clinical epidemiological features of AF and to relate them to underlying mechanisms. Long-established risk factors for AF include aging, male sex, hypertension, valve disease, left ventricular dysfunction, obesity, and alcohol consumption. Emerging risk factors include prehypertension, increased pulse pressure, obstructive sleep apnea, high-level physical training, diastolic dysfunction, predisposing gene variants, hypertrophic cardiomyopathy, and congenital heart disease. Potential risk factors are coronary artery disease, kidney disease, systemic inflammation, pericardial fat, and tobacco use. AF has substantial population health consequences, including impaired quality of life, increased hospitalization rates, stroke occurrence, and increased medical costs. The pathophysiology of AF centers around 4 general types of disturbances that promote ectopic firing and reentrant mechanisms, and include the following: (1) ion channel dysfunction, (2) Ca 2+ -handling abnormalities, (3) structural remodeling, and (4) autonomic neural dysregulation. Aging, hypertension, valve disease, heart failure, myocardial infarction, obesity, smoking, diabetes mellitus, thyroid dysfunction, and endurance exercise training all cause structural remodeling. Heart failure and prior atrial infarction also cause Ca 2+ -handling abnormalities that lead to focal ectopic firing via delayed afterdepolarizations/triggered activity. Neural dysregulation is central to atrial arrhythmogenesis associated with endurance exercise training and occlusive coronary artery disease. Monogenic causes of AF typically promote the arrhythmia via ion channel dysfunction, but the mechanisms of the more common polygenic risk factors are still poorly understood and under intense investigation. Better recognition of the clinical epidemiology of AF, as well as an improved appreciation of the underlying mechanisms, is needed to develop improved methods for AF prevention and management.

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“…Cohort studies report reduced global cognitive functioning and specific cognitive deficits in persons with atrial fibrillation, such as reduced abstract reasoning, visual and verbal memory deficits, and executive function deficits, that is, cognitive inflexibility 22 23…”

Section: Specific Cognitive Deficits In Patients With Cardiac Diseasementioning

confidence: 99%

Cardiac disease and cognitive impairment: a systematic review

Eggermont

Boer

Muller

et al. 2012

Heart

155

108

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Cognitive impairment in cardiac patients may interfere with disease management. This review describes studies examining specific cognitive impairments in cardiac patients and studies that investigate the link between echocardiographic and cognitive measures. Executive function impairments were frequently reported in different patient groups. Also, lower cardiac output and worse left ventricular diastolic function are linked to executive function deficits. In cardiac patients, special attention should be paid to these executive function impairments in view of their role in disease management and independent living. Interventions that stimulate executive function should be encouraged and integrated in cardiac treatment protocols.

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Atrial Fibrillation Is Associated With Lower Cognitive Performance in the Framingham Offspring Men

Cited by 72 publications

References 43 publications

Cognitive Consequences of Multiple Lacunes and Leukoaraiosis as Vascular Cognitive Impairment in Community-Dwelling Elderly Individuals

Cognitive Consequences of Multiple Lacunes and Leukoaraiosis as Vascular Cognitive Impairment in Community-Dwelling Elderly Individuals

The Clinical Profile and Pathophysiology of Atrial Fibrillation

Cardiac disease and cognitive impairment: a systematic review

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