Atrial fibrillation and cognitive disorders in older people

Author(s): Frisoni, G. B., Barbisoni, P., Bellelli, G., Rozzini, R., Trabucchi, M.

Journal/Book: J Amer Geriat Soc. 2000; 48: 530 Walnut St, Philadelphia, PA 19106-3621, USA. Lippincott Williams & Wilkins. 387-390.

Abstract: OBJECTIVES: To find a correlation between chronic nonrheumatic atrial fibrillation (CNRAF) and cognitive impairment in a group of older, nondemented patients. SETTING: Acute Care Unit for the Elderly, Poliambulanza Hospital, Brescia (Italy). METHODS: Two hundred fifty-five hospital in-patients older than 70 years (42 with CNRAF and 213 controls with normal sinus rhythm) were assessed by complete clinical history, physical examination, EGG, serum albumin levels, APACHE II score, mental status (Mini-Mental State Exam [MMSE] and Geriatric Depression Score [GDS]), functional status (Barthel Index and instrumental activities of daily living [IADL]), number of prescribed drugs, and comorbidity (Charlson Index). RESULTS: The group of patients with CNRAF had MMSE scores significantly lower than that of the reference group with normal sinus rhythm. Chronic nonrheumatic atrial fibrillation retained an independent relation to cognitive im pairment also alter adjusting for those variables associated with mental decline in univariate models (GDS, IADL, and APACHE IU scores). CONCLUSIONS: The results of this study support the relationship between nonrheumatic atrial fibrillation and impaired cognitive function. Independent of etiopathogenetic mechanisms (thromboembolic or hemodynamic hypotheses), prevention of cognitive impairment in older persons should take into account the treatment of atrial fibrillation and its consequences.

Note: Article Sabatini T, Geriatr Res Grp, Via Romanino 1, I-25122 Brescia, ITALY

Keyword(s): atrial fibrillation; cognitive function; older patients; WHITE-MATTER LESIONS; ASYMPTOMATIC CEREBRAL INFARCTION; VASCULAR RISK-FACTORS; ALZHEIMERS-DISEASE; LEUKO-ARAIOSIS; COMPUTED-TOMOGRAPHY; ELDERLY SUBJECTS; DEMENTIA; MRI; HYPERINTENSITIES

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