Atrial fibrillation associated with increased risk of memory decline and dementia

In addition to the 45% increased risk of MCI after AF diagnosis, the study found that older age, female sex, higher socioeconomic deprivation, clinical history of depression, stroke and multimorbidity were associated with a higher MCI risk. However, these factors did not modify the link between AF and MCI. For individuals over 74 years old, AF and MCI were frequently diagnosed when multi-comorbidity was detected, including diabetes, depression, hypercholesterolemia, and peripheral artery disease.

Patients with AF who were treated with digoxin did not experience an increased MCI risk. The risk of MCI was higher in patients with AF who did not receive oral anticoagulant treatment and amiodarone treatment. Similarly, patients with AF who received oral anticoagulant treatment and amiodarone treatment were not at risk of MCI.

During the study period, there were 1,117 individuals diagnosed with dementia on or after a diagnosis of MCI. AF was linked with a higher risk of dementia among those who had developed MCI. Sex, asthma, smoking, chronic kidney disease and multi-comorbidity were associated with an elevated subsequent dementia risk.

“Progression from MCI to dementia appears to be, at least partially, mediated by cardiovascular risk factors and the presence of multiple comorbidities,” Providencia said.

The researchers said these findings suggest that integrated AF care, such as combining anticoagulation and comorbidity-management, could help prevent cognitive deterioration and the progression to dementia. A confirmatory clinical trial is needed to explore this topic further.