What is Atrial Fibrillation?
Cognitive decline progresses around twice as fast in women than in men with atrial fibrillation, according to the new study.
Lead author Dr Kathryn Wood, of Emory University, Atlanta, Georgia, said: “Symptoms in women are often ignored by healthcare providers or attributed to stress or anxiety so it can go undiagnosed for a long period of time, while men are more likely to be diagnosed and treated quickly.
“Being undiagnosed means not receiving oral anticoagulant medication to prevent blood clots and strokes caused by atrial fibrillation.”
Her team analysed data on 43,630 adults in the US enrolled in a dementia study and tracked them for an average of four years.
Participants were required to have at least three annual clinic visits during which they took neuropsychological tests.
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They were categorised as having normal cognition, mild cognitive impairment (MCI) or full blown dementia.
Dr Wood said: “These women may be having clots that go to small blood vessels in their brain, causing them to lose brain function gradually and develop cognitive impairment.
“ESC (European Society of Cardiology) Guidelines for the care of patients with atrial fibrillation recommend oral anticoagulants for both women and men.
“However, we know that women are less likely to receive these medications than men.
“This is another reason why women may have small silent strokes that go unrecognised and damage brain tissue leading to cognitive impairment.”
Women with atrial fibrillation were three times more likely to have MCI and dementia. The odds ratios in men were just over half that.
They also had a 21 percent higher risk of progressing to a worse stage of cognitive impairment compared to peers with healthy hearts.
Those with the condition were over two and a half times more likely to transition from MCI to a form known as vascular dementia.
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They were also 17 percent more likely to go from normal cognition to MCI. The associations between atrial fibrillation and more rapid cognitive decline were not statistically significant in men.
Dr Wood added: “The analyses indicate stronger associations between atrial fibrillation and declining cognitive function in women compared with men.
“Establishing ways to identify atrial fibrillation patients at the highest risk of cognitive decline and stroke will inform future interventions to prevent or slow the progression to cognitive impairment and dementia.”
Atrial fibrillation affects around a million Britons and more than 46 million globally. It occurs when the heart’s two upper chambers go out of sync, causing an abnormal heart rhythm.
This, in turn, affects how well blood flows to the lower chambers of the heart, called the ventricles.
It can also be fixed by a simple procedure called catheter ablation. It uses radiofrequency to burn small areas of tissue causing faulty nerve messages.
A fine tube is inserted into a vein in the leg and threaded through vessels into the organ. Former prime minister Tony Blair underwent the op almost two decades ago.
But up to one patient in ten can suffer complications including a stroke, perforation of the heart muscle or dangerously low blood pressure.
Not all respond, even after multiple attempts and some are unable to have the operation due to frailty or due to previous operations on the heart.
The findings were presented at an European Society of Cardiology meeting in Edinburgh.
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