June 05, 2013
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AF associated with dementia, cognitive decline

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Older adults with incident atrial fibrillation are more likely to experience cognitive decline or develop dementia at an earlier age than those without a history of the condition, new data suggest.

“Problems with memory and thinking are common for people as they get older. Our study shows that, on average, problems with memory and thinking may start earlier or get worse more quickly in people who have atrial fibrillation. This means that heart health is an important factor related to brain health,” study researcher Evan L. Thacker, PhD, of the University of Alabama in Birmingham, said in a press release.

Thacker and colleagues performed a longitudinal analysis of participants in the Cardiovascular Health Study, which enrolled men and women aged at least 65 years from 1989 to 1990 or 1992 to 1993 with no history of clinical stroke or AF at baseline. Patients who experienced incident clinical stroke during follow-up were excluded from analyses. The primary outcome included rate of decline in mean scores on the 100-point Modified Mini-Mental State Examination (3MSE) administered annually up to nine times.

Mean follow-up was 7 years. During this time, 10.7% of the 5,150 participants included in the analysis experienced AF. Compared with those without a history of AF, mean 3MSE scores declined more quickly in participants after experiencing AF. From age 80 to 85 years, predicted 5-year decline in mean 3MSE score was –6.4 points (95% CI, –7 to –5.9) for those without AF vs. –10.3 points (95% CI, –11.8 to –8.9) for those with AF at age 80 years. Five-year difference was –3.9 points (95% CI, –5.3 to –2.5).

Scores lower than 78 points on the 3MSE are suggestive of dementia, according to Thacker. Study results indicated that older adults without AF were predicted to score lower than 78 points at age 87 years. In comparison, participants with AF were predicted to score lower than 78 points at age 85 years.

“If there is indeed a link between atrial fibrillation and memory and thinking decline, the next steps are to learn why that decline happens and how we can prevent that decline,” Thacker said.

Disclosure: Thacker reports no relevant financial disclosures. Other researchers report receiving funding from Medtronic and Merck.