Atrial fibrillation and the risk of incident dementia: A meta-analysis

Santangeli, Pasquale; Biase, Luigi Di; Bai, Rong; Mohanty, Sanghamitra; Pump, Agnes; Brantes, Mauricio Cereceda; Horton, Rodney; Burkhardt, J. David; Lakkireddy, Dhanunjaya; Reddy, Yeruva Madhu; Casella, Michela; Russo, Antonio Dello; Tondo, Claudio; Natale, Andrea

doi:10.1016/j.hrthm.2012.07.026

Cited by 241 publications

(188 citation statements)

References 36 publications

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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%

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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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.

View full text Add to dashboard Cite

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“…4 Only recently the relation between AF and cognitive impairment has become the object of investigations, reviews, and meta-analyses. [5][6][7][8][9][10][11] The Figure schematically depicts the possible mechanisms explaining the association. Beyond its well-known effect on stroke, AF may increase dementia risk through mechanisms, such as cerebral hypoperfusion or thromboembolism, causing silent cerebral infarction.…”

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confidence: 99%

Atrial Fibrillation and Cognition

Poggesi

Inzitari

Pantoni

2015

Stroke

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“…In a recent systematic review of the literature on modifiable risk factors, several studies on heart disease were identified, of which the majority reported a higher risk for cognitive impairment or dementia [8]. Some other types of heart disease have been related to cognitive decline or dementia risk, too, with most substantial evidence for atrial fibrillation [9][10][11]. A meta-analysis of 7 prospective studies found that individuals with atrial fibrillation had a 36 percent increased risk of developing cognitive impairment or dementia [9].…”

Section: Introductionmentioning

confidence: 99%

[P3–542]: Coronary Heart Disease and Risk for Cognitive Impairment or Dementia: A Systematic Review and Meta‐analysis

Deckers

Schievink

Rodriquez

et al. 2017

Alzheimer's & Dementia

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Aims/HypothesisAccumulating evidence suggests an association between coronary heart disease and risk for cognitive impairment or dementia, but no study has systematically reviewed this association. Therefore, we summarized the available evidence on the association between coronary heart disease and risk for cognitive impairment or dementia. MethodsMedline, Embase, PsycINFO, and CINAHL were searched for all publications until 8 th January 2016. Articles were included if they fulfilled the inclusion criteria: (1) myocardial infarction, angina pectoris or coronary heart disease (combination of both) as predictor variable; (2) cognition, cognitive impairment or dementia as outcome; (3) population-based study; (4) prospective (!1 year follow-up), cross-sectional or case-control study design; (5) !100 participants; and (6) aged !45 years. Reference lists of publications and secondary literature were hand-searched for possible missing articles. Two reviewers independently screened all abstracts and extracted information from potential relevant full-text articles using a standardized data collection form. Study quality was assessed with the Newcastle-Ottawa Scale. We pooled estimates from the most fully adjusted model using random-effects metaanalysis. ResultsWe identified 6,132 abstracts, of which 24 studies were included. A meta-analysis of 10 prospective cohort studies showed that coronary heart disease was associated with increased risk of cognitive impairment or dementia (OR = 1.45, 95%CI = 1.21-1.74, p<0.001). Between-study heterogeneity was low (I 2 = 25.7%, 95%CI = 0-64, p = 0.207). Similar significant associations were found in separate meta-analyses of prospective cohort studies for the individual predictors (myocardial infarction, angina pectoris). In contrast, meta-analyses of cross-sectional and case-control studies were inconclusive. Funding: The author(s) received no specific funding for this work. Competing interests:The authors have declared that no competing interests exist. Conclusion/InterpretationThis meta-analysis suggests that coronary heart disease is prospectively associated with increased odds of developing cognitive impairment or dementia. Given the projected worldwide increase in the number of people affected by coronary heart disease and dementia, insight into causal mechanisms or common pathways underlying the heart-brain connection is needed.

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Atrial fibrillation and the risk of incident dementia: A meta-analysis

Cited by 241 publications

References 36 publications

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

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

Atrial Fibrillation and Cognition

[P3–542]: Coronary Heart Disease and Risk for Cognitive Impairment or Dementia: A Systematic Review and Meta‐analysis

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