Atrial fibrillation and cognitive impairment: an associated burden or burden by association?

Journal article


Manolis, Theodora A., Manolis, Antonis A., Apostolopoulos, Evdoxia J., Melita, H. and Manolis, A. 2020. Atrial fibrillation and cognitive impairment: an associated burden or burden by association? Angiology. 71 (6), pp. 498-519. https://doi.org/10.1177/0003319720910669
AuthorsManolis, Theodora A., Manolis, Antonis A., Apostolopoulos, Evdoxia J., Melita, H. and Manolis, A.
AbstractGrowing evidence suggests that atrial fibrillation (AF), in addition to its thromboembolic risk, is a risk factor for cognitive impairment (CI) via several pathways and mechanisms, further contributing to morbidity/mortality. Prior stroke is a contributor to CI, but AF is also associated with CI independently from prior stroke. Silent brain infarctions, microemboli and microbleeds, brain atrophy, cerebral hypoperfusion from widely fluctuating ventricular rates, altered hemostatic function, vascular oxidative stress, and inflammation may all exacerbate CI, particularly in patients with persistent/permanent rather than paroxysmal AF and with increased duration/burden of the arrhythmia. Brain magnetic resonance imaging is an important screening tool in eliciting and monitoring vascular and nonvascular lesions contributing to CI. Evidence is also emerging about the role of genetics in CI development. Anticoagulation and rhythm/rate control strategies may protect against CI preventing or slowing its progression or conversion to dementia, particularly at the early stages when CI may still be a treatable condition. Importantly, AF and CI share many common risk factors. Thus, screening for these 2 conditions and searching for and managing modifiable risk factors and potentially reversible causes for both AF and CI remains an important step toward prevention or amelioration of the impact incurred by these 2 conditions.
KeywordsAtrial fibrillation; Stroke; Cognitive function; Silent cerebral infarcts; Brain hypoperfusion; Dementia; Anticoagulation; Magnetic resonance imaging
Year2020
JournalAngiology
Journal citation71 (6), pp. 498-519
PublisherSAGE Publications
ISSN0003-3197
1940-1574
Digital Object Identifier (DOI)https://doi.org/10.1177/0003319720910669
Publication dates
Online01 Apr 2020
Publication process dates
Deposited31 Oct 2022
Output statusPublished
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https://repository.canterbury.ac.uk/item/92z7z/atrial-fibrillation-and-cognitive-impairment-an-associated-burden-or-burden-by-association

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