Atrial fibrillation is associated with cognitive decline in stroke‐free subjects: the Tromsø Study

Abstract

Background and purpose Previous studies have shown associations between atrial fibrillation (AF) and cognitive decline. We investigated this association in a prospective population study, focusing on whether stroke risk factors modulated this association in stroke‐free women and men. Methods We included 4983 participants (57% women) from the fifth survey of the Tromsø Study (Tromsø 5, 2001), of whom 2491 also participated in the sixth survey (Tromsø 6, 2007–2008). Information about age, education, blood pressure, body mass index, lipids, smoking, coffee consumption, physical activity, depression, coronary and valvular heart disease, heart failure and diabetes was obtained at baseline. AF status was based on hospital records. The outcome was change in cognitive score from Tromsø 5 to Tromsø 6, measured by the verbal memory test, the digit–symbol coding test and the tapping test. Results Mean age at baseline was 65.4 years. The mean reduction in the tapping test scores was significantly larger in participants with AF (5.3 taps/10 s; 95% CI: 3.9, 6.7) compared with those without AF (3.8 taps/10 s; 95% CI: 3.5, 4.1). These estimates were unchanged when adjusted for other risk factors and were similar for both sexes. AF was not associated with change in the digit–symbol coding or the verbal memory tests. Conclusion Atrial fibrillation in stroke‐free participants was independently associated with cognitive decline as measured with the tapping test.

Mild cognitive impairment impacts health outcomes of patients with atrial fibrillation undergoing a disease management intervention

“… 9 AF is independently associated with cognitive decline, and patients with AF are at twofold higher risk of cognitive impairment than age-matched patients without AF. 10 11 Cognitive impairment is becoming increasingly recognised as exerting a powerful and negative impact on the risk profile, management and prognosis of patients with AF. 12 Higher rates of morbidity, symptom severity, healthcare utilisation and mortality resulting from the negative impact of cognitive impairment have been observed in older individuals (some with heart failure and other cardiovascular conditions) 13–16 and the same is likely to be observed in AF populations.…”

Progress in neurology 2017–2018

“…Stroke remains the most common problem for neurologists to diagnose and treat . Preventative measures, such as control of hypertension, reduction in smoking and treatment of hyperlipidaemia, have made a significant contribution to preventing and delaying stroke onset.…”