Stroke and Beyond: Cognitive Decline in Patients with Atrial Fibrillation

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“Increasing evidence suggests a link between AF and cognitive decline in the absence of major stroke,” notes Nahal Mavaddat, PhD, of the Department of Public Health and Primary Care at the University of Cambridge in the UK, and lead author of the anticoagulation study. “However, the greatest risk of dementia-onset resulting from AF remains that of having a stroke. Therefore, stroke prevention must be the clinician’s most important concern with respect to cognitive decline in those with AF,” said Dr. Mavaddat. “Anticoagulation is often underused in patients with AF who have cognitive impairment, due to concerns regarding falls and poor compliance,” added Dr. Mavaddat. “However, this may leave such patients at risk of vascular events. Clinicians should not shy away from offering anticoagulation to appropriate at-risk patients, including those with milder degrees of dementia or cognitive impairment.”