Fibrilação atrial e demência: resultados do São Paulo ageing & health study

Abstract

Background: Atrial fibrillation (AF) is a controversial risk factor for dementia.Objective: The objective of this study was to assess the association between AF and dementia in the "Sao Paulo Ageing & Health" (SPAH) study participants.Methods: SPAH is a cross-sectional, population-based study of elderly people living in a deprived neighborhood in Sao Paulo, Brazil. Dementia diagnosis was performed according to the 10/66 study group protocol based on Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. Diagnosis of AF was made using a 12-lead electrocardiogram (ECG) recording, which was assessed by two cardiologists. Data on demographics and cardiovascular risk factors were also obtained. Results: Dementia was diagnosed in 66 (4.3%) and AF in 36 (2.4%) of 1,524 participants with a valid ECG. The crude odds ratio (OR) for dementia in participants with

Atrial Fibrillation and Cognitive Impairment: New Insights and Future Directions

“…The association between dementia and some racial and ethnic groups has been confirmed in some earlier reports [88][89][90]. Most studies have been conducted in European countries such as Italy [10,23,25,33,35], Sweden [11,30], the Netherlands [21,44], the United Kingdom [22,26,50,91], Finland [12,27], France [28], Germany [29], or American countries [13,14,18,19,39,40,46,[92][93][94]; while Taiwan [43], Singapore [51], and China [52] were the only Asian countries wherein such investigations have been carried out.…”

“…Furthermore, the diagnostic method used to confirm AF was yet another important means to justify different results. For instance, some studies used ICD codes [13,30,36,37,40,43,50], while others employed electrocardiography (ECG) [13,21,22,26,27,33,[38][39][40]45,49,50], medical history, notes [10,12,13,22,25,28,30,33,34,38,42,45,49,50], and physical examinations alone or in combination with other techniques [12,25,30,49]. In addition, in some studies, no Figure 2 Worldwide distribution of national studies investigating association between atrial fibrillation and cognitive function.…”

International Collaborative Partnership for the Study of Atrial Fibrillation (INTERAF): Rationale, Design, and Initial Descriptives

“…For example, Americans of either Hispanic ethnicity or African‐American race appear to have higher stroke risks, despite a lower prevalence of AF relative to white individuals . Asians with AF may have particularly high risks for stroke, potentially due to variations in both anticoagulant prescribing practices and variable genetic‐based responses to anticoagulation with warfarin . Similar variation in thromboembolism risk and outcomes may also occur in other regions, but comprehensive global assessments of thromboembolism outcomes, particularly in developing countries, are lacking.…”

“…A meta‐analysis of 21 studies found decreased cognitive scores associated with AF in different populations . In Brazil, AF patients were 2.8 times more likely to have dementia, relative to those without AF . AF also is associated with chronic kidney disease.…”

“…8,11 Asians with AF may have particularly high risks for stroke, potentially due to variations in both anticoagulant prescribing practices and variable genetic-based responses to anticoagulation with warfarin. [12][13][14][15] Similar variation in thromboembolism risk and outcomes may also occur in other regions, but comprehensive global assessments of thromboembolism outcomes, particularly in developing countries, are lacking. AF is also associated with other causes of morbidity, including coronary artery disease, dementia, chronic kidney disease, and HF.…”