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Med J Aust 2019; 211 (2): . || doi: 10.5694/mja2.50252
Published online: 15 July 2019

Atrial fibrillation (AF) is linked with an increased risk of dementia, including in people who have not had a stroke, according to a Korean study published in the European Heart Journal. The study also found that patients with AF who took oral anticoagulants to prevent blood clots had a reduced risk of dementia. AF is the most common heart rhythm problem among older people, and more than half the people with AF are aged 80 years or more. It increases the risks of stroke, other medical problems, and death. As populations age, the incidence of AF is expected to increase, and there is some evidence that AF may contribute to the development of cognitive problems and dementia. The investigators analysed data for 262 611 people in the Korea National Health Insurance Service – Senior cohort aged 60 years or more and without AF and dementia in 2004. By the end of 2013, AF had been diagnosed in 10 435 people, of whom 2522 (24.4%) had developed dementia during the follow‐up period; 36 322 (14.4%) AF‐free people had developed dementia. “We found that the people who developed AF had a 50% increased risk of developing dementia compared to those who did not develop the condition; this increased risk remained even after we removed those who suffered a stroke from our calculations. This means that, among the general population, an extra 1.4 people per 100 of the population would develop dementia if they were diagnosed with AF. We also found that AF increased the risk of Alzheimer's disease by 30% and more than doubled the risk of vascular dementia. However, among people who developed AF who took oral anticoagulants… the risk of subsequently developing dementia reduced by 40% compared to patients who did not take anticoagulants.”



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