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Review
. 2019 Mar;8(1):8-12.
doi: 10.15420/aer.2018.75.2.

Atrial Fibrillation and Dementia: Exploring the Association, Defining Risks and Improving Outcomes

T Jared Bunch  1   2 , Oxana Galenko  1 , Kevin G Graves  3 , Victoria Jacobs  1 , Heidi T May  1
Affiliations
Review

Atrial Fibrillation and Dementia: Exploring the Association, Defining Risks and Improving Outcomes

T Jared Bunch et al. Arrhythm Electrophysiol Rev. 2019 Mar.

Abstract

AF is strongly associated with a spectrum of cranial injuries including stroke and dementia. Dementia risk is seen in patients with and without a prior stroke and includes idiopathic forms of dementia, such as Alzheimer's disease. The initiation, use and efficacy of anticoagulation have been shown in multiple observational trials to have an impact on dementia risk. Cerebral hypoperfusion during AF can result in cognitive decline and patients with cranial atherosclerosis may have unique susceptibility. Therapies to carefully control the ventricular rate and catheter ablation have been shown in observational trials to lower dementia risk. There is a need for further research in multiple areas and the observational trials will require prospective trials confirmation. Recent guidelines for AF have advocated the initiation of effective anticoagulation, the treatment of associated disease conditions that may influence the progression of AF and catheter ablation, with long-term management of risk factors to lower risk of dementia.

Keywords: AF; ageing; anticoagulants; cognition; dementia; stroke.

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Conflict of interest statement

Disclosure: TJB is the recipient of research grants from Boston Scientific and Boehringer Ingelheim, but receives no personal compensation. All other authors have no conflicts of interest to declare.

Figures

Figure 1:
Figure 1:. Spectrum of Brain Injury in Patients with AF
Figure 2:
Figure 2:. Mechanisms of Risk of Cognitive Decline and Dementia in Patients with AF
See this image and copyright information in PMC

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