Patients with atrial fibrillation are more likely to develop dementia, a meta-analysis confirms, regardless of stroke history. Pooling the results of 14 studies, researchers found the risk of cognitive impairment was 40% greater in patients with AF.

The increased risk existed regardless of whether subjects had a history of stroke. But the risk was nearly tripled in patients who had both AF and stroke, the researchers reported after examining a further seven studies.

Both cognitive impairment and dementia showed similar increases in risk with AF, the authors concluded in the Annals of Internal Medicine.

Dementia, cognitive impairment, and AF share similar risk factors, including age, hypertension, congestive heart failure and diabetes, the authors said.

This could explain the association between them, but also meant that dealing with confounding variables was important. However there could be other mechanisms at play, they wrote.

Patients with AF might be in a “hypercoagulable state” or thrombi in the left atrial appendage might be thrown out, leading to clinical and subclinical strokes.

Stroke was self-reported in many of the studies and not confirmed by scans, meaning the meta-analysis could not rule out silent stroke could be the cause.

Brain hypoperfusion due to beatto-beat variability, the proinflammatory state in AF and the periventricular white-matter lesions might
also explain the link, the authors said, but these remain untested.

Longitudinal studies, with careful adjustment for confounders, were needed to clarify the nature of the association, they concluded.

Article first published in Neurology Update March 05

Image thanks to washingtoninjuryattorneyblog.com

Atrial fibrillation (AF) is the most common form of arrhythmia – a problem with the rate, or rhythm, of the heartbeat. It is believed to affect more than six million people worldwide.

According to the London Atrial Fibrillation Centre, part of London Bridge Hospital, many people notice that when they are “in AF” they cannot do as much as they could when their heart is in normal rhythm. And because AF is a chronic condition, “It is not uncommon for patients to be surprised at what they can do when restored to normal rhythm and feel worse if they return to AF because they have been reminded what it is like to be in normal rhythm.”

AF carries some significant health risks including stroke. It is generally accepted that this risk is greatly reduced by the drug warfarin in high risk patients and aspirin in low risk patients.

About 30 per cent of people with AF have no symptoms and it is discovered by chance however, according to the London AF Centre website www.londonafcentre.co.uk, most people will experience a combination of the following symptoms:

1.    Palpitation (a feeling that your heart is racing, going faster than normal or beating in an irregular way)
2.    Shortness of breath
3.    Lethargy
4.    Dizzy spells or fainting
5.    Chest pain
6.    Symptoms of stroke (transient or permanent weakness to one side of the body, speech or visual impairment).

These are the features of AF discovered when a health professional examines you. A rapid and irregular pulse is the commonest sign of AF and is usually the way in which it is discovered in people without any symptoms.

While there are not many options available now to treat AF there are some drug and surgical therapies that are being researched all over the world. In fact, AF treatment as a research activity has gained a lot of traction in medical research even in the last 10 years.

Do you or does anyone you know have AF? Would you be interested in sharing your story with the Australian media and public?

Later this year, The National Stroke Foundation will announce the results of a new study into the impact of atrial fibrillation on the Australian health system.  To increase awareness of AF and the impact on stroke we will be speaking with media outlets across the country.

We would like the media to hear the individual view, so we are inviting you to help by telling your story.

We are hoping to speak to people from a variety of ages and range of life situations such as professionals, retirees, parents, grandparents, etc who fit the following profile:

•    Has had a stroke as a result of having AF
•    Has AF but has not had a stroke
•    Is a carer of a person who has AF as a result of a stroke
•    Is a carer of a person who has AF but has not had a stroke

If you would like to take part, please contact Janelle Yates at the National Stroke Foundation jyates@strokefoundation.com.au or 9670 1000.