Studies show an AF diagnosis can lead to memory issues in some patients.
A recent study published in JACC: Advances has uncovered a compelling association between atrial fibrillation (AF) diagnosis and a concerning 45% elevated risk of mild cognitive impairment (MCI) within a substantial cohort of 4.3 million individuals in the United Kingdom.
This revelation raises pivotal questions regarding the role of cardiovascular risk factors and the influence of comorbidities in the potential transition from MCI to dementia within this cohort. MCI, often recognized as an early stage of cognitive function decline, serves as a significant harbinger of potential dementia-associated diseases.
The dearth of comprehensive research regarding the development of MCI in AF patients and the subsequent progression to dementia has spurred the authors of this groundbreaking study to delve into the intricate relationship between MCI and AF diagnosis in the UK. Atrial fibrillation (AF) is a common cardiac arrhythmia characterized by irregular and often rapid heartbeats.
Once diagnosed, the management and treatment of AF may involve medications, lifestyle modifications, or, in some cases, invasive procedures like catheter ablation or electrical cardioversion to restore normal heart rhythm. Early diagnosis and appropriate management are crucial for mitigating the risk of complications associated with AF, including stroke and cognitive decline.
The study’s senior author, Dr. Rui Providencia, MD, PhD, a Full Professor at the Institute of Health Informatics Research at University College London, asserts, suggested that AF could lead to a 45% increase MCI risk. He also suggested that the cardiovascular risk factors and multi-comorbidity are direct descendants of the treatment.
He based these statements on an extensive analysis of the UK primary electronic health record data, encompassing 4.3 million individuals.
The study scrutinized the risk of MCI following AF diagnosis, discerning two cohorts: one consisting of 233,833 individuals with incident AF and the other comprising 233,747 individuals without AF. The findings revealed that beyond the 45% augmented risk of MCI subsequent to AF diagnosis, several additional factors contributed to this risk, including:
- Age: The risk of MCI escalated with increasing age, particularly among those over 74 years old.
- Gender: Female individuals exhibited a higher risk of MCI compared to their male counterparts.
- Socioeconomic Deprivation: Higher levels of socioeconomic deprivation were correlated with an elevated MCI risk.
- Clinical History: Individuals with a clinical history of depression, stroke, and multimorbidity had an increased MCI risk.
- Comorbid Conditions: Conditions such as diabetes, hypercholesterolemia, peripheral artery disease, and depression were significantly associated with the risk of MCI, particularly among those over 74 years old.
An intriguing facet of the study was the varying impact of different treatments on the risk of MCI among AF patients. Notably, individuals with AF who were treated with digoxin did not experience an increased risk of MCI.
Conversely, those without the digoxin faced a higher risk of MCI. Conversely, patients with AF who received oral anticoagulant treatment and amiodarone treatment did not exhibit an increased risk of MCI. These findings underscore the intricate relationship between treatment regimens and cognitive risk in AF patients.
Throughout the study period, 1,117 individuals received a dementia diagnosis after being diagnosed with MCI. Notably, AF was found to be significantly linked with a heightened risk of dementia among those who had previously developed MCI. Furthermore, factors such as gender, asthma, smoking, chronic kidney disease, and multimorbidity were associated with an elevated subsequent risk of dementia.
Dr. Providencia and his team suggest that moving from MCI to dementia is somewhat arbitrated by cardiovascular risk elements. Furthermore, there was also an existence of several co-morbidities in the mix. These findings showcase the need for a comprehensive and integrated approach to AF care.