RT Journal Article
T1 Atrial Fibrillation and Dementia: A Report From the AF-SCREEN International Collaboration.
A1 Rivard, Lena
A1 Friberg, Leif
A1 Conen, David
A1 Healey, Jeffrey S
A1 Berge, Trygve
A1 Boriani, Giuseppe
A1 Brandes, Axel
A1 Calkins, Hugh
A1 Camm, A John
A1 Yee-Chen, Lin
A1 Lluis-Clua-Espuny, Josep
A1 Collins, Ronan
A1 Connolly, Stuart
A1 Dagres, Nikolaos
A1 Elkind, Mitchell S V
A1 Engdahl, Johan
A1 Field, Thalia S
A1 Gersh, Bernard J
A1 Glotzer, Taya V
A1 Hankey, Graeme J
A1 Harbison, Joseph A
A1 Haeusler, Karl G
A1 Hills, Mellanie T
A1 Johnson, Linda S B
A1 Joung, Boyoung
A1 Khairy, Paul
A1 Kirchhof, Paulus
A1 Krieger, Derk
A1 Lip, Gregory Y H
A1 Løchen, Maja-Lisa
A1 Madhavan, Malini
A1 Mairesse, Georges H
A1 Montaner, Joan
A1 Ntaios, George
A1 Quinn, Terence J
A1 Rienstra, Michiel
A1 Rosenqvist, Mårten
A1 Sandhu, Roopinder K
A1 Smyth, Breda
A1 Schnabel, Renate B
A1 Stavrakis, Stavros
A1 Themistoclakis, Sakis
A1 Van-Gelder, Isabelle C
A1 Wang, Ji-Guang
A1 Freedman, Ben
K1 atrial fibrillation
K1 cognitive dysfunction
K1 dementia
AB Growing evidence suggests a consistent association between atrial fibrillation (AF) and cognitive impairment and dementia that is independent of clinical stroke. This report from the AF-SCREEN International Collaboration summarizes the evidence linking AF to cognitive impairment and dementia. It provides guidance on the investigation and management of dementia in patients with AF on the basis of best available evidence. The document also addresses suspected pathophysiologic mechanisms and identifies knowledge gaps for future research. Whereas AF and dementia share numerous risk factors, the association appears to be independent of these variables. Nevertheless, the evidence remains inconclusive regarding a direct causal effect. Several pathophysiologic mechanisms have been proposed, some of which are potentially amenable to early intervention, including cerebral microinfarction, AF-related cerebral hypoperfusion, inflammation, microhemorrhage, brain atrophy, and systemic atherosclerotic vascular disease. The mitigating role of oral anticoagulation in specific subgroups (eg, low stroke risk, short duration or silent AF, after successful AF ablation, or atrial cardiopathy) and the effect of rhythm versus rate control strategies remain unknown. Likewise, screening for AF (in cognitively normal or cognitively impaired patients) and screening for cognitive impairment in patients with AF are debated. The pathophysiology of dementia and therapeutic strategies to reduce cognitive impairment warrant further investigation in individuals with AF. Cognition should be evaluated in future AF studies and integrated with patient-specific outcome priorities and patient preferences. Further large-scale prospective studies and randomized trials are needed to establish whether AF is a risk factor for cognitive impairment, to investigate strategies to prevent dementia, and to determine whether screening for unknown AF followed by targeted therapy might prevent or reduce cognitive impairment and dementia.
PB Lippincott Williams & Wilkins
YR 2022
FD 2022-01-31
LK http://hdl.handle.net/10668/20198
UL http://hdl.handle.net/10668/20198
LA en
NO Rivard L, Friberg L, Conen D, Healey JS, Berge T, Boriani G, et al. Atrial Fibrillation and Dementia: A Report From the AF-SCREEN International Collaboration. Circulation. 2022 Feb;145(5):392-409. doi: 10.1161/CIRCULATIONAHA.121.055018. Epub 2022 Jan 31. Erratum in: Circulation. 2022 Apr 19;145(16):e842.
DS RISalud
RD Apr 18, 2025