Early Cognitive disorders – a predictor of Dementia in patients with atrial fibrillation after 45 to 65 years of age

Abstract

Atrial fibrillation (AF) is the most common cardiac arrhythmia. It is characterized by uncoordinated atrial activation and ineffective atrial contraction. It mainly affects the elderly persons and it is a proven risk factor for heart failure, myocardial infarction, ischemic stroke and mortality. (1) In the last decade the disease AF is increasingly associated pathogenetically and morphologically with an increased risk of developing of cognitive disorders (CD) as an independent risk factor for the onset of dementia. (2) There is still a lack of consensus regarding a definitive interpretation of the findings by a number of authors and described a correlation between AF Dementia. The Framingham and Rotterdam studies estimated that the lifetime risk of developing AF in adults >40 years and age 55 years, respectively, was approximately 1 in 4 (3).
The study and significance of such a relationship, its predictors and potential underlying pathogenetic mechanisms could inform and alert to the creation of effective strategies regarding the control of AF disease at a younger, at-risk age and for the early prevention of adverse cognitive outcomes in carrier patients. The prevalence of AF shows a strong age dependence, ranging from 0.5% in patients aged <40 years to 5% in patients aged >65 years. The present review comprises some epidemiological aspects of AF and dementia and the pathogenetic mechanisms responsible for the appearance of early cognitive disorders in patients of the risk age (between 45 and 65 years old), correlating both with abnormal neuropsychological indicators and with structural changes of the brain (proven by MRI) – predictors of dementia.