Why the study?
Do NOACs prevent cognitive impairment and dementia better than warfarin in elderly patients with atrial fibrillation?
Do NOACs prevent cognitive impairment and dementia better than warfarin in elderly patients with atrial fibrillation?
NOACs, particularly rivaroxaban, may be more effective and safer than warfarin for preventing cognitive impairment and dementia in elderly patients with atrial fibrillation.
May support preferring NOACs over warfarin in elderly AF to reduce cognitive risks; leaves open confirmation by dedicated RCTs.
This article presents an overview of data of Russian and foreign literature on possible associations between cognitive impairment and atrial fibrillation (AF). It includes modern classification of cognitive impairment, mechanisms of the effect of AF on cognitive functions and development of dementia, recommendations for the prevention of cognitive impairment in patients with AF. Special attention is paid to the assessment of cognitive status, and safe anticoagulant therapy, which is a priority in the prevention of cognitive impairment in patients with AF. Analysis of literature showed greater efficacy and safety of drugs from the group of Non-vitamin K Antagonist Oral Anticoagulants (NOAC), rivaroxaban in particular, in comparison with warfarin. Drugs from the NOAC group can be recommended for prevention stroke, cognitive impairment and dementia in elderly patients with AF.
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Остроумова et al. (2018) studied this question.
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