Study reveals women with atrial fibrillation (AF) face a higher risk of rapid cognitive decline compared to men.
Atrial fibrillation (AF) has been found to significantly increase the risk of accelerated cognitive decline in women, according to a recent study. The analysis of data from the National Alzheimer’s Coordinating Center (NACC) cohort suggests that women with AF have a threefold greater likelihood of developing mild cognitive impairment (MCI) and dementia compared to women without AF. Surprisingly, no significant association between AF and cognitive decline was observed in men.
The large-scale study involved an examination of a diverse group of participants, and the results indicate that AF poses a substantial risk to women’s cognitive health. The odds ratio (OR) for women with AF developing MCI was found to be 3.00, with a 95% confidence interval (CI) of 1.22–7.37. Similarly, women with AF had an OR of 3.43 (95% CI, 1.55–7.55) for developing dementia, compared to women without AF.
Further analysis revealed that women with AF and normal cognition at the start of the study had an increased risk of progressing to MCI over time, with a hazard ratio (HR) of 1.26 (95% CI, 1.06–1.50). Additionally, women with AF and existing MCI faced a higher risk of transitioning to vascular dementia, with an HR of 3.27 (95% CI, 1.89–5.65). In contrast, men with AF and both men and women without AF did not exhibit a significant association with cognitive decline.
Dr. Kathryn Wood, the lead author of the study from Emory University, Atlanta, Georgia, emphasized the stronger link between AF and cognitive decline in women compared to men. These findings shed light on the potential clinical implications, as healthcare providers often overlook or misdiagnose AF symptoms in women as stress or anxiety, leading to delayed diagnosis and treatment. In contrast, men tend to receive quicker diagnoses and subsequent treatment.
It is worth noting that AF, the most common heart rhythm disorder affecting over 40 million people worldwide, has been linked to a more than twofold increase in the risk of silent strokes. Silent strokes refer to strokes that do not exhibit obvious symptoms but can cause small brain injuries that accumulate over time, resulting in cognitive impairment.
The study’s results underscore the importance of recognizing and addressing AF in women promptly. By failing to diagnose AF, women miss out on vital treatments such as oral anticoagulants that can prevent blood clots and strokes associated with AF. Undiagnosed women with AF may experience blood clots that travel to small blood vessels in the brain, leading to gradual brain function loss and the development of cognitive impairment.
The study involved 43,630 individuals with an average age of 78.5 years, of which 46% were women. Participants underwent neuropsychological tests during at least three annual clinic visits and were categorized into three groups: normal cognition, MCI, or dementia. Out of the participants, 4,593 (11%) had AF at the beginning of the study.
Over a median follow-up period of four years, 30% of the participants experienced a worsening stage of cognitive impairment, and 21% received a diagnosis of dementia.
The findings highlight the urgent need to identify AF patients, especially women, who are at the highest risk of cognitive decline and stroke. Such identification will enable the development of interventions aimed at preventing or slowing down the progression to cognitive impairment and dementia.
In conclusion, the study provides valuable insights into the relationship between AF and cognitive decline, particularly in women. The higher risk observed in women emphasizes the importance of timely AF diagnosis and treatment, as well as the need for further research to develop targeted interventions that can help prevent or mitigate cognitive impairment and dementia in individuals with AF.