Atrial fibrillation: A major risk factor for cognitive decline

Hui, Dawn S.; Morley, John E.; Mikolajczak, Peter; Lee, Richard

doi:10.1016/j.ahj.2014.12.015

Cited by 77 publications

(62 citation statements)

References 83 publications

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“…by guest on May 12, 2018 http://hyper.ahajournals.org/ Downloaded from Atrial fibrillation is another factor which has been described as associated to dementia. 25 However, in our study sample, if we noticed a slightly significant higher frequency of atrial fibrillation in subject with OH (3.46% versus 2.30%; P=0.0372), atrial fibrillation was not associated to incident dementia (hazard ratio, 1.18; 95% confidence interval, 0.71-1.895; P=0.503). Furthermore, the higher the prominence of OH, the stronger the association, with an increased risk of dementia of 50% observed for severe OH.…”

Section: Figurementioning

confidence: 68%

Orthostatic Hypotension and Risk of Incident Dementia

et al. 2017

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Abstract-Several studies indicate a potential link between orthostatic hypotension (OH) and incident dementia but without substantial evidence to date. Our objective is to study the association between OH and dementia in a cohort of elderly individuals. To do so, baseline lying and standing blood pressure measurements were taken from 7425 subjects in the Three-City study. These subjects were then followed-up for 12 years. Cox proportional hazard models, adjusted for potential confounders, were used to estimate the risk of incident dementia according to OH status. Sensitivity analysis was performed using the so-called illness-death model, a specific statistical method which takes into account competitive risk with death. OH frequency was found to be around 13%, and 760 cases of dementia were diagnosed during followup. We observed significant associations between the presence of OH at baseline and the occurrence of dementia during the follow-up, with an increased risk of at least 25% observed regardless of the OH threshold and the statistical method used. In conclusion, there is an association between OH and dementia. Considering that OH is a common condition and is easy to measure, OH measurements could help to identify subjects with higher risk of dementia. Moreover, reducing OH could be a step to prevent conversion to dementia.

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Section: Figurementioning

confidence: 68%

Orthostatic Hypotension and Risk of Incident Dementia

et al. 2017

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“…Several different kinds of observational works-such as meta-analyses [12][13][14], reviews [15,16], and cross-sectional [17][18][19], cohort and longitudinal [20][21][22][23][24][25] studies-confirm an independent association between AF and cognitive decline at differing grades of severity.…”

Section: Introductionmentioning

confidence: 99%

“…Recently, the role of SCIs in cognitive function during AF has been assessed through magnetic resonance imaging [6]. Although some of the haemodynamic consequences of AF, such as lower diastolic cerebral perfusion and decreased blood flow in the intracranial arteries, have been reported ( [8,9,15] and references therein), the linking mechanisms with cognitive impairment remain theoretical or mainly undetermined.…”

Section: Introductionmentioning

confidence: 99%

Alteration of cerebrovascular haemodynamic patterns due to atrial fibrillation: an in silico investigation

Scarsoglio

Saglietto

Anselmino

et al. 2017

J. R. Soc. Interface.

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There has recently been growing evidence that atrial fibrillation (AF), the most common cardiac arrhythmia, is independently associated with the risk of dementia. This represents a very recent frontier with high social impact for the number of individuals involved and for the expected increase in AF incidence in the next 40 years. Although a number of potential haemodynamic processes, such as microembolisms, altered cerebral blood flow, hypoperfusion and microbleeds, arise as connecting links between the two pathologies, the causal mechanisms are far from clear. An in silico approach is proposed that combines in sequence two lumped-parameter schemes, for the cardiovascular system and the cerebral circulation. The systemic arterial pressure is obtained from the cardiovascular system and used as the input for the cerebral circulation, with the aim of studying the role of AF on the cerebral haemodynamics with respect to normal sinus rhythm (NSR), over a 5000 beat recording. In particular, the alteration of the haemodynamic (pressure and flow rate) patterns in the microcirculation during AF is analysed by means of different statistical tools, from correlation coefficients to autocorrelation functions, crossing times, extreme values analysis and multivariate linear regression models. A remarkable signal alteration, such as a reduction in signal correlation (NSR, about 3 s; AF, less than 1 s) and increased probability (up to three to four times higher in AF than in NSR) of extreme value events, emerges for the peripheral brain circulation. The described scenario offers a number of plausible cause-effect mechanisms that might explain the occurrence of critical events and the haemodynamic links relating to AF and dementia.

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“…It is associated with greater risk of both cardiological and non-cardiological complications, including a decrease in health-related quality of life, cardiac failure, stroke, and death [1,2]. This type of arrhythmia is also related to cognitive impairment [3][4][5][6][7][8]. This form of mental disorder may appear in patients both with organic lesions on neuroradiological brain examination (indicative of, for example, ischaemic stroke, silent cerebral ischaemia, silent brain infarct, damage in the blood vessels of the brain, white matter lesions, or loss of cortical, subcortical, or hippocampal volume) and without [6,[9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Links between parameters of long-term latent memory and progression from paroxysmal to permanent atrial fibrillation during a five-year observation period. A preliminary study

Mietła

Budzyński²,

Bieliński³

et al. 2016

Kardiol Pol

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A b s t r a c t Background and aim:As cognitive function is the most vulnerable human feature, its impairment may precede the occurrence of symptoms of cardiovascular system disorders, e.g. atrial fibrillation (AF). In this way, cognitive impairment may not only be a complication of AF, but also a marker of its progression. This study aims to test this hypothesis. Methods:Of 35 patients with AF, 23 (66%) had paroxysmal and 12 (34%) had permanent arrhythmia at the start of the study. At both the start of the study and after 5.86 ± 3.7-7.05 years of follow-up, the following neuropsychological tests were performed using the Beck Depression Inventory, Parts A and B of the Trail Making Test, eight trials from the Rey Auditory Verbal Learning Test (RAVLT), and the Stroop test. Results:Patients who maintained paroxysmal AF for the whole study observation period (n = 10) had a significantly greater score in the sixth (A6) and seventh (A7) RAVLT trials (pertaining to parameters of long-term latent memory) at the start of the study. An association between lower RAVLT A6 and A7 trial scores and the risk of paroxysmal arrhythmia progression to permanent AF was confirmed using the Cox proportional hazards regression model and Kaplan-Meier survival analysis. Conclusions:A better long-term latent memory RAVLT score was associated with a favourable prognosis of sinus rhythm maintenance. Cognitive impairment should be investigated in patients with AF for the purpose of evaluating the patient's prognosis, subclinical injury to the cardiovascular system, and the ability to comply with treatment.

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Atrial fibrillation: A major risk factor for cognitive decline

Cited by 77 publications

References 83 publications

Orthostatic Hypotension and Risk of Incident Dementia

Orthostatic Hypotension and Risk of Incident Dementia

Alteration of cerebrovascular haemodynamic patterns due to atrial fibrillation: an in silico investigation

Links between parameters of long-term latent memory and progression from paroxysmal to permanent atrial fibrillation during a five-year observation period. A preliminary study

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