Unchecked Atrial Fibrillation's Impact on Mental Decline: A Possible Connection Explored
Untreated Atrial Fibrillation (AFib) Linked to Higher Risk of Dementia
A new study published in JACC: Advances has found an association between untreated AFib and a higher risk of developing mild cognitive impairment (MCI), which in turn increases the risk of dementia [1].
The research, which analysed electronic health records of 4,309,245 individuals in the United Kingdom over an 18-year period, found that people with AFib who developed MCI were at a 45% higher risk of developing dementia compared to those without AFib or with treated AFib [2].
AFib, a common heart condition that disrupts normal heart rhythm, can lead to blood clots, strokes, and reduced blood flow to the brain. These complications can contribute to cognitive decline and increase dementia risk [3].
The study matched each of the 233,833 people with AFib with a control of the same sex and age without AFib. It adjusted for a wide range of potential MCI risk factors, including hypertension, smoking, diabetes, high cholesterol, heart failure, stroke, cancer, hearing loss, thyroid disease, depression, chronic kidney and liver disease, and chronic obstructive pulmonary disease (COPD) [1].
The study found that people with AFib treated with digoxin, amiodarone, and oral anticoagulants were not at a higher risk of MCI compared to controls [2]. However, it noted that Amiodarone, an antiarrhythmic medication, is still in use for AFib treatment, but it is not as frequently prescribed due to side effects [4].
In the earlier years of the study, the most common treatment for AFib was digoxin, but it is not recommended for treatment anymore [5]. Cardiac ablation, a procedure that destroys small areas of heart tissue to prevent abnormal heartbeats, is now one of the first-line therapies for AFib and is about 70-80% effective [6]. It is frequently supplemented with anticoagulants.
The study also found an association between AFib and chronic kidney disease [1]. Asthma is a potential co-morbidity in individuals with AFib [7].
The researchers emphasized that managing AFib with appropriate medical care and monitoring helps reduce the risk of strokes and cognitive decline, preserving brain function and lowering dementia risk [2][4]. They also noted that smoking is a potential risk factor for MCI [8].
In conclusion, routine monitoring of heart conditions, blood pressure, and early treatment for AFib are essential in mitigating the risks associated with AFib and dementia. Ignoring AFib or delaying treatment can result in serious long-term cognitive consequences.
[1] The study can be found at: https://www.sciencedirect.com/science/article/pii/S266879812200044X [2] The study was published as a research letter in JACC: Advances. [3] [1] [4] [2] [5] [3] [6] [6] [7] [7] [8] [8]
