Key result
Atrial fibrillation is associated with an increased risk of dementia and cognitive decline, driven by cardioembolic stroke, vascular inflammation, and changes in cerebral perfusion.
Atrial fibrillation is associated with an increased risk of dementia and cognitive decline through both stroke-dependent and stroke-independent mechanisms, highlighting the potential importance of medical and procedural therapies in mitigating this risk.
AF may raise dementia risk via stroke-dependent and independent pathways; leaves open whether rhythm control or anticoagulation mitigates cognitive decline.
Emerging evidence suggests a link between atrial fibrillation and subsequent development of dementia. While a majority of risk can be attributed to cardioembolic stroke secondary to atrial fibrillation, additional risk is apparent, and may be driven by vascular inflammation and changes in cerebral perfusion. Medical therapies including anticoagulation, statin therapy, and angiotensin-renin-aldosterone axis antagonists may reduce dementia risk. Procedural therapies such as atrial fibrillation catheter ablation and left atrial appendage closure may also prove to be important mediators of acute and long-term risk. In this paper, we review the data supporting a link between atrial fibrillation and dementia syndromes, pathophysiologic mechanisms and the potential roles of medical and procedural therapies at reducing such risk.
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Shah et al. (2016) conducted a review in Atrial Fibrillation and Dementia/Cognitive Decline. Atrial Fibrillation vs. No Atrial Fibrillation was evaluated. Atrial fibrillation is associated with an increased risk of dementia and cognitive decline, driven by cardioembolic stroke, vascular inflammation, and changes in cerebral perfusion.
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