8 research outputs found
Atrial Fibrillation Is Associated with Cognitive Impairment, All-Cause Dementia, Vascular Dementia, and Alzheimer's Disease: a Systematic Review and Meta-Analysis
Background Atrial fibrillation (AF) is a risk factor for cognitive
impairment and dementia in patients with stroke history. However, the
association between AF and cognitive impairment in broader populations
is less clear. Objective To systematically review and quantitatively
synthesize the existing evidence regarding the association of AF with
cognitive impairment of any severity and etiology and dementia. Methods
Medline, Scopus, and Cochrane Central were searched in order to identify
studies investigating the association between AF and cognitive
impairment (or dementia) cross-sectionally and longitudinally. Studies
encompassing and analyzing exclusively patients with stroke history were
excluded. A random-effects model meta-analysis was conducted. Potential
sources of between-study heterogeneity were investigated via subgroup
and meta-regression analyses. Sensitivity analyses including only
studies reporting data on stroke-free patients, vascular dementia, and
Alzheimer’s disease were performed. Results In total, 43 studies were
included. In the pooled analysis, AF was significantly associated with
dementia (adjusted OR, 1.6; 95% CI, 1.3 to 2.1; I-2, 31%) and the
combined endpoint of cognitive impairment or dementia (pooled adjusted
OR, 1.5; 95% CI, 1.4 to 1.8; I-2, 34%). The results were significant,
even when studies including only stroke-free patients were pooled
together (unadjusted OR, 2.2; 95% CI, 1.4 to 3.5; I-2, 96%), but the
heterogeneity rates were high. AF was significantly associated with
increased risk of both vascular (adjusted OR, 1.7; 95% CI, 1.2 to 2.3;
I-2, 43%) and Alzheimer’s dementia (adjusted HR, 1.4; 95% CI, 1.2 to
1.6; I-2, 42%). Conclusion AF increases the risk of cognitive
impairment, all-cause dementia, vascular dementia, and Alzheimer’s
disease. Future studies should employ interventions that may delay or
even prevent cognitive decline in AF patients
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