Untreated AFib may raise the risk of cognitive decline Untreated AFib may raise the risk of cognitive decline

Untreated AFib may raise the risk of cognitive decline

  • A new research letter suggests that those who have not received treatment for atrial fibrillation (AFib) are at greater risk of mild cognitive impairment and, potentially, dementia.

  • The research determined that individuals whose Atrial Fibrillation (AFib) is managed effectively do not have an increased risk of cognitive difficulty.

  • Atrial fibrillation may cause the formation of tiny, unnoticeable blood clots, which can lead to a gradual deterioration of the brain's capabilities.

  • Those who have multiple health conditions in addition to AFib that have not been treated have a higher chance of developing mild cognitive impairment and dementia.

Results from a comprehensive study suggested a link between the presence of atrial fibrillation, which is left unmanaged, and the future development of mild cognitive impairment, which could potentially lead to dementia.

The study showed that individuals who had been diagnosed with Atrial Fibrillation were almost half as likely to develop Mild Cognitive Impairment compared to those who had not been diagnosed or had their condition managed.


The study demonstrated that individuals taking a combination of digoxin, amiodarone, and blood thinning medication did not experience an increased risk of developing MCI in comparison to the control group.

Can AFib cause dementia?

A survey of medical records from more than 4 million people living in the EU was conducted from 1998 to 2016.

The study included 233,833 individuals with AFib and an equal amount of people without AFib for comparison. The average age of the participants was 74.2 years old.

The scientists took into account a variety of possible influences that might contribute to the risk of developing Mild Cognitive Impairment, including:

  • High cholesterol

  • Hearing loss

  • Thyroid disease

  • Chronic obstructive pulmonary disease (COPD)

  • Diabetes

  • Smoking

  • Peripheral artery disease

  • Heart failure

  • Hypertension

  • Depression

  • Chronic kidney and liver disease

  • Sex

  • Age

  • Cancer

  • Socioeconomic status

  • Atherosclerotic heart disease

  • Obesity

  • Stroke

Atrial fibrillation, particularly when inadequately managed, has been associated with the occurrence of multiple small embolic strokes. These strokes, often unnoticed by the individual, can result in damage to brain tissue and cells, similar to silent heart attacks. Atrial fibrillation is recognised as a risk factor for these silent brain injuries.

Over time, these silent brain infarcts can have a detrimental impact on cognitive function, hastening mental decline. This is because untreated atrial fibrillation can lead to the formation of small blood clots, which have the potential to block the small arteries responsible for supplying oxygen to the brain. Consequently, the brain may be deprived of oxygen, leading to tissue damage and cell death.

Ultimately, these strokes can reduce the volume of healthy brain tissues, potentially contributing to cognitive impairment and, in some cases, the development of dementia.

Who is at the highest risk for cognitive impairment?

The researchers discovered that certain people were more likely to experience MCI, such as those with a link to AFib.

  • Older people

  • Females

  • People who’ve had a stroke

  • People with more significant socioeconomic deprivation

  • Individuals with a clinical history of depression

Furthermore, the study indicated that individuals with atrial fibrillation (AFib) who developed mild cognitive impairment (MCI) faced an elevated risk of progressing to dementia. The following factors were identified as the primary contributors to this heightened dementia risk:

  • Smoking

  • Biological sex

  • Chronic kidney disease

  • Asthma

  • Multiple comorbidities

The research findings showed that all 20 comorbidity variables were frequently more prevalent in the AFib group, with some being more than twice as prevalent as in the control group. One noteworthy comorbidity often overlooked was hearing loss, associated with an increased risk of cognitive decline.

What to know about AFib

Atrial fibrillation, a type of arrhythmia, is characterised by an irregular or quivering heartbeat. It can give rise to various cardiovascular complications, such as:

  • Stroke

  • Formation of blood clots

  • Heart failure

Currently, more than 7.6 million people over 65 in the EU are affected by AFib, and it is anticipated that this number will increase to 14.4 million by 2060, driven by the ageing population.

AFib results from irregular heartbeats in the heart's upper chambers, known as the atria. This irregular beating can lead to the retention of some blood in the heart, which may form clots. These clots can be transported to the brain, leading to the occurrence of a stroke.

What is the most common treatment for atrial fibrillation?

The study discussed two medicines, digoxin and amiodarone, used more in the past but less today.

Digoxin is not recommended as the primary treatment for atrial fibrillation anymore. It's mainly used to control heart rate.

Amiodarone, another medicine, is still used but not as often because it has many side effects.

Instead, there's a newer method called cardiac ablation. It became a popular treatment around the early 2000s. Here's how it works: Doctors use a minimally invasive procedure where they go through the veins in the legs to reach the heart. Then, they fix the heart tissue that's causing atrial fibrillation by burning it. This is different from just using medicine to cover up the problem.

But here's the thing: cardiac ablation isn't always 100% effective, so doctors often give patients blood thinners along with it to reduce risks.

Atrial fibrillation isn't just about the heart; it can also affect the brain. So, managing all the other health problems that come with atrial fibrillation is essential. If you don't, it could worsen the risk of memory problems as you age.

Mobi Doctor can help by providing guidance and treatment options for individuals with atrial fibrillation, ensuring they receive the proper care and support for their heart health.


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