Early-Onset Dementia Risk in Atrial Fibrillation

Citing recent studies that identified an increased risk of dementia in patients with atrial fibrillation (AF), Maria Edvige Giannone and colleagues explored associations between AF and early-onset dementia. Based on their meta-analysis, they concluded that patients with AF did have increased risk for dementia, particularly in the 60 to 69 years age range—though it was not as pronounced as the risk reported in patients aged over 70 years.

The meta-analysis, published in the Journal of the American Heart Association, ultimately included six cohort studies with approximately 1.6 million pooled participants for analyses. Mean age at enrollment ranged from 42 to 85, and follow-up ranged from 1 month to 8 years. The primary outcome of the analysis was the incidence of dementia in patients with no history of AF and the incidence in patients with history of AF or an AF diagnosis at enrollment.

Dementia Onset in Adult Patients with Atrial Fibrillation

In total, 3,647 patients from the included studies had a reported dementia outcome, the authors noted. Primarily, the researchers estimated an increased risk of developing dementia in patients with AF, with a relative risk of 1.50 (95% confidence interval [CI], 1.00-2.26) for patients aged less than 70 years, and 1.06 (95% CI, 0.55-2.06) for those less than 65 years. Though the mechanisms of AF that increase the risk of early-onset dementia are still unclear, the authors theorized potential causes, including cerebral hypoperfusion, brain atrophy induced by altered cerebral blood flow, and a decrease in cardiac output due to loss of atrial systole and atrioventricular synchrony.

The study’s findings were limited by the limited number of studies that met the inclusion criteria and the high degree of heterogeneity between them, which was potentially a function of age of participants. Additionally, the researchers were unable to investigate if AF type and duration affected the increased risk for developing dementia.

Ultimately, Giannone and colleagues concluded that AF does appear to increase risk for onset of dementia, even in patients aged less than 70 years. However, they acknowledged that “further research is needed to assess which characteristics of the arrhythmia and which mechanisms play a role in this relationship.” If you know an elderly loved one who’s currently experiencing this, then maybe it’s time to look for memory care community options or assisted living homes. Visit sites like crescendoseniorliving.com/services/ for additional guidance.

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