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Relationship between atrial fibrillation and cognitive decline in individuals aged 80 and older

  • Marco Proietti
    Affiliations
    Department of Neuroscience, Laboratory of Quality Assessment of Geriatric Therapies and Services, IRCCS – Istituto di Ricerche Farmacologiche “Mario Negri”, Milan, Italy

    University of Birmingham Institute of Cardiovascular Sciences, Birmingham, United Kingdom
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  • Angela Recchia
    Affiliations
    Department of Neuroscience, Laboratory of Geriatric Neuropsychiatry, IRCCS – Istituto di Ricerche Farmacologiche “Mario Negri”, Milan, Italy
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  • Emma Riva
    Affiliations
    Department of Neuroscience, Laboratory of Geriatric Neuropsychiatry, IRCCS – Istituto di Ricerche Farmacologiche “Mario Negri”, Milan, Italy
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  • Ugo Lucca
    Affiliations
    Department of Neuroscience, Laboratory of Geriatric Neuropsychiatry, IRCCS – Istituto di Ricerche Farmacologiche “Mario Negri”, Milan, Italy
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  • Mauro Tettamanti
    Affiliations
    Department of Neuroscience, Laboratory of Geriatric Neuropsychiatry, IRCCS – Istituto di Ricerche Farmacologiche “Mario Negri”, Milan, Italy
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  • Pier Mannuccio Mannucci
    Affiliations
    Scientific Direction, IRCCS Ca' Granda Maggiore Policlinico Hospital Foundation, Milan, Italy
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  • Alessandro Nobili
    Correspondence
    Corresponding author at: Department of Neuroscience, Laboratory of Quality Assessment of Geriatric Therapies and Services, IRCCS – Istituto di Ricerche Farmacologiche “Mario Negri”, Via Giuseppe La Masa 19, 20156 Milan, Italy.
    Affiliations
    Department of Neuroscience, Laboratory of Quality Assessment of Geriatric Therapies and Services, IRCCS – Istituto di Ricerche Farmacologiche “Mario Negri”, Milan, Italy
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Published:August 09, 2017DOI:https://doi.org/10.1016/j.ejim.2017.08.010

      Highlights

      • Relationship between atrial fibrillation (AF) and dementia is largely established.
      • Scarce data are available about AF determining dementia in very old subjects.
      • The limited data available does not support AF causative role for dementia in older.
      • Poor anticoagulation control is associated with higher risk of dementia in older AF.
      • Data from larger studies are still needed to clarify this relationship.

      Abstract

      Background

      Atrial fibrillation (AF) and dementia are largely prevalent and incident in progressively older subjects, suggesting a link between the two conditions. While in the general population there are several findings supporting a causal relationship between AF and dementia, it is unclear whether or not this association is still present in individuals aged 80 and older.

      Results

      So far, the few studies that analysed this issue did not provide enough evidence supporting the causative role of AF in increasing the risk of cognitive decline or dementia in patients aged 80 and older. Conversely, a relevant role of optimal anticoagulation control in determining a significant reduction in the risk of cognitive decline is suggested, in AF subjects aged 80 years or older.

      Conclusions

      Further data, coming from population-based studies specifically investigating very old individuals and based upon large samples and comprehensive cognitive assessments, are needed to fully elucidate the relationship between AF and dementia in very old individuals.

      Keywords

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