Key result
Atrial fibrillation linked to lower cognitive performance and working memory versus healthy controls.
Why the study?
Atrial fibrillation is linked to cognitive decline, but the specific cognitive domains most affected remain incompletely understood, and standard screening tests can lead to delayed diagnosis.
Is atrial fibrillation associated with reduced cognitive function and working memory compared to healthy controls?
Cross-Sectional (n=208)
Is atrial fibrillation associated with reduced cognitive function and working memory compared to healthy controls?
Atrial fibrillation is associated with reduced performance in working memory and general cognitive functioning compared to healthy controls.
Answers are grounded in this paper and cite their sources.
AF associated with cognitive deficits; hypothesis-generating and requires prospective validation before changing practice.
Background/Introduction Atrial fibrillation is strongly associated with cognitive decline and increased risk of dementia, but the cognitive domains that are most affected have not yet been fully elucidated. The most widely used neuropsychological tests [i.e. Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE)] can assess the general levels of cognitive function. Moreover, they are influenced by the social and demographic characteristics of the examinee, and typically lead to delayed diagnosis. The REMEDES for Alzheimer (R4Alz) battery, based on the REMEDES system, is a new tool that can efficiently identify cognitive decline in specific domains (working memory, attention, inhibitory control, and executive function) in a timely manner. Purpose To assess cognitive function and working memory in patients with atrial fibrillation. Methods The population of this cross-sectional observational study consisted of patients with atrial fibrillation, without a history of stroke,and adjusted healthy controls, with comparable clinical characteristics. Demographic and clinical data were collected, and all participants underwent the MoCA and R4Alz cognitive tests during a single visit. The primary endpoint was the difference in psychometric test performance between the two groups. Results 139 patients with a history of atrial fibrillation (paroxysmal: 65.5%, persistent: 18%, permanent: 16.5%) and 69 healthy controls were included in the study (mean age: 61.5 years, women: 49.5%). Significant differences were observed between the two groups in terms of performance on the MoCA test (25.1 ± 3.8 vs. 26.3 ± 4.3, p = 0.002) (Picture 1), but also in the R4Alz working memory tests (WMCUT 1: 17 ± 3.6 vs. 19.4 ± 4.5, p < 0.001, WMCUT 2: 16.3 ± 4 vs. 18.6 ± 4.1, p < 0.001, WMCUT: 33.3 ± 7.3 vs. 38 ± 8.2, p < 0.001) (Picture 2). Performance on the two tests showed a statistically significant positive correlation (r = 0.60, p < 0.001). Conclusions Atrial fibrillation is associated with reduced performance in the cognitive domain of working memory, to a proportional degree to the reduction in general cognitive functioning. Newer psychometric batteries which assess specific cognitive domains may lead to earlier and more accurate diagnosis of cognitive dysfunction in patients with atrial fibrillation.
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Triantafyllou et al. (2026) conducted a cross-sectional in Atrial fibrillation (n=208). Atrial fibrillation vs. Healthy controls was evaluated on Difference in psychometric test performance between the two groups (MoCA score) (p=0.002). Atrial fibrillation was associated with significantly lower cognitive performance compared to healthy controls on the MoCA test (25.1 vs 26.3, p=0.002) and R4Alz working memory tests (p<0.001).
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