Relationship between atrial fibrillation and cognitive decline in individuals aged 80 and older

Proietti, Marco; Recchia, Angela; Riva, Emma; Lucca, Ugo; Tettamanti, Mauro; Mannucci, Pier Mannuccio; Nobili, Alessandro

doi:10.1016/j.ejim.2017.08.010

Cited by 17 publications

(11 citation statements)

References 31 publications

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“…18 However, this association does not appear as clear in patients aged >80 years. 19 patients followed for 5 years, reported an independent association between AF and any type of dementia (vascular, senile, Alzheimer's disease and indeterminate); however, stratifying by age was only significant in those aged <79 years. Therefore, in extreme ages there appear to be other factors (inflammation, prothrombotic state, cerebral hypoperfusion etc.)…”

Section: Discussionmentioning

confidence: 92%

“…In general, AF is independently associated with an increased risk of dementia, as described in a meta‐analysis with eight prospective studies and a mean follow‐up period of 8 years . However, this association does not appear as clear in patients aged >80 years . Bunch et al , in a cohort of 70 000 patients followed for 5 years, reported an independent association between AF and any type of dementia (vascular, senile, Alzheimer's disease and indeterminate); however, stratifying by age was only significant in those aged <79 years.…”

Section: Discussionmentioning

confidence: 98%

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Prevalence of atrial fibrillation and associated anticoagulant therapy in the nonagenarian population of the Community of Madrid, Spain

Lahoz¹,

Cárdenas

Salinero-Fort

et al. 2018

Geriatrics Gerontology Int

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Aims The objective of the present study was to evaluate the prevalence of atrial fibrillation (AF) in nonagenarians living in the Community of Madrid, their clinical features, the use of anticoagulant therapy and factors associated with its use. Methods This was a cross‐sectional study of 59 423 individuals aged ≥90 years, living in the Community of Madrid on 31 December 2015. Clinical information was obtained from a database that includes information from electronic medical records collected by 3881 general practitioners in primary care. Results Some 16.95% of nonagenarians (n = 10 077) were diagnosed with atrial fibrillation. These individuals have a higher prevalence of classic risk factors and established cardiovascular disease, as well as higher comorbidity. Of these, 67.6% received anticoagulant therapy, 27.9% received antiplatelet agents and 7.2% received both treatments simultaneously. Of the participants administered anticoagulation, 11.6% received a direct oral anticoagulant. The use of anticoagulant therapy was associated with a younger age, the presence of heart failure or venous thromboembolism, the absence of hypertension, a higher Barthel Index score, a greater number of prescribed drugs, a higher body mass index and a lower Charlson Comorbidity Index score. Conclusions Nonagenarians with atrial fibrillation have a high risk of stroke; however, high comorbidity and functional impairment have limited the use of anticoagulant therapy. Geriatr Gerontol Int 2019; 19: 203–207.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 98%

Prevalence of atrial fibrillation and associated anticoagulant therapy in the nonagenarian population of the Community of Madrid, Spain

Lahoz¹,

Cárdenas

Salinero-Fort

et al. 2018

Geriatrics Gerontology Int

View full text Add to dashboard Cite

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“…However, palpitations are more commonly seen in Paroxysmal AFIB as opposed to shortness of breath which is more common in Persistent/Permanent AFIB. Other common non-specific presentations include fatigue, lightheadness and lethargy [40]. However, not all the times atrial rhythm abnormalities are symptomatic: Paroxysmal AFIB patients more frequently present as asymptomatic [41].…”

Section: Clinical Featuresmentioning

confidence: 99%

Management of atrial fibrillation-flutter: uptodate guideline paper on the current evidence

Shah

Luu

Calestino

et al. 2018

Journal of Community Hospital Internal Medicine Perspectives

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The term ‘flutter’ and ‘fibrillation’ were first coined to differentiate the differences between fast, regular contractions in Atrial Flutter (AFLUT) with irregular, vermiform contractions of Atrial Fibrillation (AFIB). Management of these two diseases has been a challenge for physicians. Rate control (along with rhythm control) is the first line of management for symptomatic AFIB/AFLUT with Rapid Ventricular Rate (RVR). In some situations, atrial rhythms may not be well controlled by these anti-arrhythmic drugs, making cardioversion to sinus rhythm necessary. Anti-coagulation therapy in both the disease population is essential. Catheter ablation is an effective treatment option in certain patients that have AFIB/AFLUT refractory to medical management. Newer techniques like left atrial appendage (LAA) has been developed and is a highly attractive concept for the future in the management of AFIB/AFLUT. Newer novel drugs targeting specific ion channels are approaching the stages of clinical investigation. However, while advances in technologies have helped elucidate many aspects of these diseases, many mysteries still remain. This literature review serves as one of the guideline papers for current up-to-date management on both AFIB and AFLUT.

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“…A recent cross‐sectional study indicated that in individuals with heart failure with reduced and preserved systolic ejection fraction, AF was associated with an adjusted higher odds of presence and severity of prevalent cognitive impairment . (≥80 years) the relationship between AF and dementia seems to be mostly mediated by concomitant risk factors …”

Section: Atrial Fibrillation and Cognitive Functionmentioning

confidence: 99%

“…86 (≥80 years) the relationship between AF and dementia seems to be mostly mediated by concomitant risk factors. 87 The relationship between AF and cognitive decline may occur through a variety of pathological mechanisms. Given the relationship between AF and stroke, vascular dementia may be an obvious contributor to cognitive decline, encompassing both multi-infarct dementia and SVD dementia.…”

Section: Atrial Fibrillation Silent Stroke and Cognitive Functionmentioning

confidence: 99%

European Heart Rhythm Association (EHRA)/Heart Rhythm Society (HRS)/Asia Pacific Heart Rhythm Society (APHRS)/Latin American Heart Rhythm Society (LAHRS) expert consensus on arrhythmias and cognitive function: What is the best practice?

Dagres

Chao

Fenelon

et al. 2018

Journal of Arrhythmia

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Relationship between atrial fibrillation and cognitive decline in individuals aged 80 and older

Cited by 17 publications

References 31 publications

Prevalence of atrial fibrillation and associated anticoagulant therapy in the nonagenarian population of the Community of Madrid, Spain

Prevalence of atrial fibrillation and associated anticoagulant therapy in the nonagenarian population of the Community of Madrid, Spain

Management of atrial fibrillation-flutter: uptodate guideline paper on the current evidence

European Heart Rhythm Association (EHRA)/Heart Rhythm Society (HRS)/Asia Pacific Heart Rhythm Society (APHRS)/Latin American Heart Rhythm Society (LAHRS) expert consensus on arrhythmias and cognitive function: What is the best practice?

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