August 17, 2020Circulation103 citations
View Full PaperAtrial Fibrillation and Dementia
Key Result
Atrial fibrillation is associated with the development of dementia through mechanisms like altered brain perfusion, highlighting the need for prospective trials on anticoagulation and rhythm control.
Structured PICO
P
Population
Patients with atrial fibrillation with and without a history of stroke
Atrial fibrillation is mechanistically linked to dementia, suggesting potential therapeutic opportunities through anticoagulation and rhythm/rate control that require prospective evaluation.
Abstract
Atrial fibrillation is associated with multiple adverse comorbidities, including the development of dementia in patients with and without a history of stroke. Mechanistic models have been proposed to explain the association of AF and dementia. Alterations of brain perfusion from embolic events, bleeding, and rhythm-related hypoperfusion underlie many of these models. Multiple mediators such as oxidative injury, inflammatory and autoimmune mechanisms, and genetic predisposition also interplay in the disease association. There are potential therapeutic opportunities to reduce dementia risk, including early and effective use of anticoagulation and strategies to improve brain perfusion through rhythm and rate control approaches. Prospective trials are needed to evaluate these therapeutic opportunities that carefully measure cognitive function and dementia incidence.