Atrial fibrillation as a risk factor for cognitive impairment: a semi-systematic review

被引:52
作者
Udompanich, S. [1 ]
Lip, G. Y. H. [2 ]
Apostolakis, S. [2 ]
Lane, D. A. [2 ]
机构
[1] Univ Birmingham, Sch Med, Birmingham B15 2TT, W Midlands, England
[2] Univ Birmingham, Ctr Cardiovasc Sci, City Hosp, Birmingham B18 7QH, W Midlands, England
关键词
SILENT BRAIN INFARCTS; STROKE-FREE PATIENTS; DEMENTIA; DECLINE; COHORT;
D O I
10.1093/qjmed/hct129
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
It is unclear if atrial fibrillation (AF) is an independent risk factor for cognitive impairment. This review evaluates the available evidence and provides an overview of the association between AF and cognitive function. Electronic database searches, January 1990 to December 2012, identified 271 studies comparing the incidence of cognitive impairment and/or dementia in patients with/without AF. Cognitive function was diagnosed by a physician using the mini-mental state examination (MMSE) or other established diagnostic criteria. Studies with <20 participants and without direct comparison to controls in sinus rhythm were excluded. There were no restrictions on the basis of age, language or study design. Full texts of 11 studies were obtained. Eight studies (three cross-sectional, two case-control and three prospective cohorts) reported an association between cognitive decline and AF. Among cross-sectional studies, patients with AF had a 1.7 (95% CI 1.2-2.5) to 3.3 (95% CI 1.6-6.5) greater risk of cognitive impairment, and a 2.3-fold (95% CI 1.4-3.7) increased risk of dementia, compared to patients in sinus rhythm. There was marked heterogeneity in the design, size and quality of studies and reporting of the data which precluded formal meta-analysis. Eight studies reported an association between AF and cognitive impairment and/or dementia, but the magnitude of risk varied. Further large-scale prospective studies are needed to establish whether AF is a risk factor for cognitive decline, utilizing objective measures of cognitive function and neuropsychological testing, and to investigate the potential benefit of anticoagulation on reducing cognitive impairment and development of dementia.
引用
收藏
页码:795 / 802
页数:8
相关论文
共 25 条
[1]  
[Anonymous], 2012, CMAJ
[2]   Dementia in subjects with atrial fibrillation: hemostatic function and the role of anticoagulation [J].
Barber, M ;
Tait, RC ;
Scott, J ;
Rumley, A ;
Lowe, GDO ;
Stott, DJ .
JOURNAL OF THROMBOSIS AND HAEMOSTASIS, 2004, 2 (11) :1873-1878
[3]   Patients Treated with Catheter Ablation for Atrial Fibrillation Have Long-Term Rates of Death, Stroke, and Dementia Similar to Patients Without Atrial Fibrillation [J].
Bunch, T. Jared ;
Crandall, Brian G. ;
Weiss, J. Peter ;
May, Heidi T. ;
Bair, Tami L. ;
Osborn, Jeffrey S. ;
Anderson, Jeffrey L. ;
Muhlestein, Joseph B. ;
Horne, Benjamin D. ;
Lappe, Donald L. ;
Day, John D. .
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, 2011, 22 (08) :839-845
[4]   Atrial fibrillation is independently associated with senile, vascular, and Alzheimer's dementia [J].
Bunch, T. Jared ;
Weiss, J. Peter ;
Crandall, Brian G. ;
May, Heidi T. ;
Bair, Tami L. ;
Osborn, Jeffrey S. ;
Anderson, Jeffrey L. ;
Muhlestein, Joseph B. ;
Horne, Benjamin D. ;
Lappe, Donald L. ;
Day, John D. .
HEART RHYTHM, 2010, 7 (04) :433-437
[5]  
Cicconetti Paolo, 2004, Recenti Progressi in Medicina, V95, P535
[6]  
Elias Merrill F, 2006, J Stroke Cerebrovasc Dis, V15, P214, DOI 10.1016/j.jstrokecerebrovasdis.2006.05.009
[7]  
Farina E, 1997, ACTA NEUROL SCAND, V96, P310
[8]   VALIDITY OF THE MoCA AND MMSE IN THE DETECTION OF MCI AND DEMENTIA IN PARKINSON DISEASE [J].
Kasten, Meike ;
Bruggemann, Norbert ;
Schmidt, Alexander ;
Klein, Christine .
NEUROLOGY, 2010, 75 (05) :478-478
[9]   Atrial fibrillation is an independent determinant of low cognitive function -: A cross-sectional study in elderly men [J].
Kilander, L ;
Andrén, B ;
Nyman, H ;
Lind, L ;
Boberg, M ;
Lithell, H .
STROKE, 1998, 29 (09) :1816-1820
[10]   Comprehensive risk reduction in patients with atrial fibrillation: Emerging diagnostic and therapeutic options Executive summary* of the report from the 3rd AFNET/EHRA consensus conference [J].
Kirchhof, Paulus ;
Lip, Gregory Y. H. ;
Van Gelder, Isabelle C. ;
Bax, Jeroen ;
Hylek, Elaine ;
Kaeaeb, Stefan ;
Schotten, Ulrich ;
Wegscheider, Karl ;
Boriani, Giuseppe ;
Ezekowitz, Michael ;
Diener, Hans ;
Heidbuchel, Hein ;
Lane, Deirdre ;
Mont, Luis ;
Willems, Stephan ;
Dorian, Paul ;
Vardas, Panos ;
Breithardt, Guenter ;
Camm, A. John .
THROMBOSIS AND HAEMOSTASIS, 2011, 106 (06) :1012-1019