AFib linked to significant risk of memory loss, mild cognitive impairment

LONDON — Atrial fibrillation (AFib) increases the odds of numerous cardiovascular emergencies such as heart attack or stroke. Now, new research is revealing an association between this most common form of irregular heartbeat and memory loss. Scientists are reporting a new AFib diagnosis displays a link to a concerning 45-percent increased risk of mild cognitive impairment (MCI) among a sample of 4.3 million people living in the United Kingdom.

Study authors say these findings show cardiovascular risk factors and multiple co-morbidities may amplify the progression from MCI, leading to full-blown dementia among these patients.

Researchers consider MCI an early stage of cognitive decline. While it can be reversed in some cases, it can also indicate the development of early dementia-associated disease. Up until now, study authors say there hasn’t been enough research on the development of MCI among AFib patients and the eventual possible development of dementia. So, researchers working with the American College of Cardiology decided to conduct this study in order to investigate the association between MCI and AF diagnosis in the United Kingdom.

“Our study showed that AF was associated with a 45% increase in the risk of MCI, and that cardiovascular risk factors and multi-comorbidity appear to associate with this outcome,” says Rui Providencia, MD, PhD, Full Professor at the Institute of Health Informatics Research at University College London and the study’s senior author, in a media release.

Heart and brain connection
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The research team made use of U.K. primary electronic health record (EHR) data encompassing 4.3 million people to analyze the risk of MCI following an AFib diagnosis. This approach led to the identification of 233,833 individuals with incident AFib and 233,747 without AFib.

Besides the 45-percent increased risk of MCI following an AFib diagnosis, the study also reports older age, being a woman, more socioeconomic deprivation, a clinical history of depression, stroke, and multiple pre-existing conditions all had an association with a higher MCI risk. Those factors, however, didn’t actually modify the connection between AFib and MCI. Among those older than 74 years-old, AFib and MCI were often diagnosed when multi-comorbidity was detected, such as diabetes, depression, hypercholesterolemia, and peripheral artery disease.

AFib patients treated with digoxin did not display an increased risk of MCI. However, MCI risk was higher among those with AFib who did not receive oral anticoagulant treatment and amiodarone treatment. Similarly, patients with AFib who received oral anticoagulant treatment and amiodarone treatment were not considered to be at risk of MCI.

Over the course of the study period, a total of 1,117 people were diagnosed with dementia on or after being diagnosed with MCI. AFib, on the other hand, only displayed a link to a higher dementia risk among those with MCI. Multiple factors, including gender, asthma, smoking, chronic kidney disease, and multi-comorbidity, had an association with higher subsequent dementia risk.

“Progression from MCI to dementia appears to be, at least partially, mediated by cardiovascular risk factors and the presence of multiple co-morbidities,” Prof. Providencia concludes.

The study is published in JACC: Advances.

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