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AF linked to high risk for cognitive impairment, dementia
Risk for cognitive impairment and dementia appears to increase with the presence of atrial fibrillation, independent of stroke history, according to data published in the Annals of Internal Medicine.
For the meta-analysis, researchers reviewed 21 studies reporting the risks of AF and cognitive impairment.
Shadi Kalantarian
Independent of stroke, AF was associated with a significantly higher risk for cognitive impairment (RR=1.34; 95% CI, 1.13-1.58). In patients with first-ever or recurrent stroke, the researchers reported a more than twofold increase in risk for cognitive impairment after stroke (RR=2.7; 95% CI, 1.82-4.00). Risk remained significant in a broader population of patients with or without a history of stroke (RR=1.4; 95% CI, 1.19-1.64). When researchers limited the meta-analysis to include only prospective studies, results were similar (RR for cognitive impairment=1.36; 95% CI, 1.12-1.65). Including dementia outcomes did not change risk estimates significantly (RR=1.38; 95% CI, 1.22-1.56).
"Although this meta-analysis must be interpreted in the context of the limitations of the studies included, it provides the most comprehensive evidence to date on the potential effects of AF on cognitive impairment," Shadi Kalantarian, MD, MPH, from the cardiac arrhythmia service and the Institute for Heart, Vascular and Stroke Care at Massachusetts General, and colleagues wrote in the study. "It also highlights critical gaps in our knowledge about the mechanisms underlying the association between AF and cognitive impairment."
Disclosure: The researchers report no relevant financial disclosures.