Impact of atrial fibrillation on the rate of mild cognitive impairment in the elderly

Крупенин, П. М.; Габитова, М. А.; Bordovsky, S. P.; Kirichuk, Yana; Napalkov, D. А.; Preobrazhenskaya, I. S.; Соколова, А. А.

doi:10.1016/j.jns.2018.08.023

Cited by 6 publications

(4 citation statements)

References 16 publications

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“…[18][19][20] Specifically, in this sensitivity analysis, we included studies that used a global score derived from scores of three or more sensitive neuropsychological tests for detection of cognitive impairment 21 [examples of tests that were combined for a global score were Delayed Word Recall Test (DWRT), Digit Symbol Substitution Test (DSST) of the Wechsler Adult Intelligence Scale-Revised, Word Fluency Test (WFT), logical memory immediate and delayed recall, incidental learning from the Wechsler Memory Scale-III, trail making test parts A and B, WAIS-R digits span backward, Boston naming test, and animal naming]. 19,20 We also included studies [22][23][24] that used singular sensitive diagnostic tests for detection of MCI, specifically, Montreal Cognitive Assessment (MoCA) or Modified Mini-Mental State Examination (3MS). 19,20 Finally, studies that adopted the modified Petersen criteria for diagnosis of MCI were included in this analysis, since their implementation requires careful clinical review of cognitive symptoms and cognitive testing 25 The random-effects model was used to account for heterogeneity within and between studies.…”

Section: Data Synthesis and Analysismentioning

confidence: 99%

Atrial Fibrillation Is Associated with Cognitive Impairment, All-Cause Dementia, Vascular Dementia, and Alzheimer’s Disease: a Systematic Review and Meta-Analysis

et al. 2021

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BACKGROUND: Atrial fibrillation (AF) is a risk factor for cognitive impairment and dementia in patients with stroke history. However, the association between AF and cognitive impairment in broader populations is less clear. OBJECTIVE: To systematically review and quantitatively synthesize the existing evidence regarding the association of AF with cognitive impairment of any severity and etiology and dementia. METHODS: Medline, Scopus, and Cochrane Central were searched in order to identify studies investigating the association between AF and cognitive impairment (or dementia) cross-sectionally and longitudinally. Studies encompassing and analyzing exclusively patients with stroke history were excluded. A random-effects model meta-analysis was conducted. Potential sources of between-study heterogeneity were investigated via subgroup and meta-regression analyses. Sensitivity analyses including only studies reporting data on stroke-free patients, vascular dementia, and Alzheimer's disease were performed. RESULTS: In total, 43 studies were included. In the pooled analysis, AF was significantly associated with dementia (adjusted OR, 1.6; 95% CI, 1.3 to 2.1; I 2 , 31%) and the combined endpoint of cognitive impairment or dementia (pooled adjusted OR, 1.5; 95% CI, 1.4 to 1.8; I 2 , 34%). The results were significant, even when studies including only stroke-free patients were pooled together (unadjusted OR, 2.2; 95% CI, 1.4 to 3.5; I 2 , 96%), but the heterogeneity rates were high. AF was significantly associated with increased risk of both vascular (adjusted OR, 1.7; 95% CI, 1.2 to 2.3; I 2 , 43%) and Alzheimer's dementia (adjusted HR, 1.4; 95% CI, 1.2 to 1.6; I 2 , 42%). CONCLUSION: AF increases the risk of cognitive impairment, all-cause dementia, vascular dementia, and Alzheimer's disease. Future studies should employ interventions that may delay or even prevent cognitive decline in AF patients.

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Section: Data Synthesis and Analysismentioning

confidence: 99%

Atrial Fibrillation Is Associated with Cognitive Impairment, All-Cause Dementia, Vascular Dementia, and Alzheimer’s Disease: a Systematic Review and Meta-Analysis

et al. 2021

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“…Even when the analysis was restricted to certain study designs, significant findings were still observed for the combined endpoint of CImp and/or dementia. There was a significant correlation in 23 prospective studies 12,22,24,26,29–31,33,35,36,38,39,41,42,43,44,46–52 (OR: 1.57; 95% CI: 1.38, 1.75; df: 22; I 2 = 79.278%). A significant correlation was also seen in cross-sectional studies, which included 4 studies 25,27,34,45 (OR: 2.06; 95% CI: 1.16, 2.96; df: 3; I 2 = 84.313%).…”

Section: Resultsmentioning

confidence: 94%

“…Sub-groups that used more sensitive neuropsychological tests 12,18,22,26–29,31,33–40,42,44–46 rather than relying simply on MMSE testing, showed that AF was substantially associated with an increased risk of CImp (OR: 1.60, 95% CI: 1.31, 1.88, df: 19, I 2 = 96.367%). Similarly, AF was shown to be substantially linked with CImp in subgroups that solely underwent MMSE testing 23,24,30,41,47–52 (OR: 1.70, 95% CI: 1.52, 1.87, df: 9, I 2 = 53.896%).…”

Section: Resultsmentioning

confidence: 99%

The Link Between Atrial Fibrillation And Cognitive Impairment: A Systematic Review And Meta-Analysis

Agarwal,

Mostafa,

Ahmad

et al. 2023

Preprint

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Atrial fibrillation (AF) affects a substantial population of individuals aged ≥55 years globally and has been associated with an increased risk of cognitive impairment (CImp) due to the shared risk factors such as aging, obesity, and diabetes. It is essential to comprehend their unique relationship to manage them effectively to reduce its impact on public health systems. We performed a PubMed search of English language papers published till 31 May 2023. Data was extracted and effect measures were calculated. Meta-analysis of 33 studies revealed a significant association between AF and CImp after adjusting for comorbidities, with considerable between-study heterogeneity (pooled OR: 1.62; 95% CI: 1.43, 1.81, I2 = 94.143). Prospective and cross-sectional studies revealed substantial associations. CImp in AF may be mediated through silent brain infarctions, microemboli, brain atrophy, and inflammation. Future research should prioritize investigating the mechanisms and etiology of this association, as well as potential treatment options.

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“…Other studies have emphasized the significance of blood pressure control in cognitive performance, indicating that uncontrolled hypertension may have a higher impact than AF on MCI. 99…”

Section: Risk Factors and Markersmentioning

confidence: 99%

Atrial Fibrillation and Cognitive Impairment: An Associated Burden or Burden by Association?

Manolis

Apostolopoulos

et al. 2020

Angiology

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Growing evidence suggests that atrial fibrillation (AF), in addition to its thromboembolic risk, is a risk factor for cognitive impairment (CI) via several pathways and mechanisms, further contributing to morbidity/mortality. Prior stroke is a contributor to CI, but AF is also associated with CI independently from prior stroke. Silent brain infarctions, microemboli and microbleeds, brain atrophy, cerebral hypoperfusion from widely fluctuating ventricular rates, altered hemostatic function, vascular oxidative stress, and inflammation may all exacerbate CI, particularly in patients with persistent/permanent rather than paroxysmal AF and with increased duration/burden of the arrhythmia. Brain magnetic resonance imaging is an important screening tool in eliciting and monitoring vascular and nonvascular lesions contributing to CI. Evidence is also emerging about the role of genetics in CI development. Anticoagulation and rhythm/rate control strategies may protect against CI preventing or slowing its progression or conversion to dementia, particularly at the early stages when CI may still be a treatable condition. Importantly, AF and CI share many common risk factors. Thus, screening for these 2 conditions and searching for and managing modifiable risk factors and potentially reversible causes for both AF and CI remains an important step toward prevention or amelioration of the impact incurred by these 2 conditions.

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Impact of atrial fibrillation on the rate of mild cognitive impairment in the elderly

Cited by 6 publications

References 16 publications

Atrial Fibrillation Is Associated with Cognitive Impairment, All-Cause Dementia, Vascular Dementia, and Alzheimer’s Disease: a Systematic Review and Meta-Analysis

Atrial Fibrillation Is Associated with Cognitive Impairment, All-Cause Dementia, Vascular Dementia, and Alzheimer’s Disease: a Systematic Review and Meta-Analysis

The Link Between Atrial Fibrillation And Cognitive Impairment: A Systematic Review And Meta-Analysis

Atrial Fibrillation and Cognitive Impairment: An Associated Burden or Burden by Association?

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