Atrial fibrillation and cognitive disorders in older people

OBJECTIVES: To find a correlation between chronic nonrheumatic atrial fibri llation (CNRAF) and cognitive impairment in a group of older, nondemented p atients. SETTING: Acute Care Unit for the Elderly, Poliambulanza Hospital, Brescia (Italy). METHODS: Two hundred fifty-five hospital in-patients older than 70 years (4 2 with CNRAF and 213 controls with normal sinus rhythm) were assessed by co mplete clinical history, physical examination, EGG, serum albumin levels, A PACHE II score, mental status (Mini-Mental State Exam [MMSE] and Geriatric Depression Score [GDS]), functional status (Barthel Index and instrumental activities of daily living [IADL]), number of prescribed drugs, and comorbi dity (Charlson Index). RESULTS: The group of patients with CNRAF had MMSE scores significantly low er than that of the reference group with normal sinus rhythm. Chronic nonrh eumatic atrial fibrillation retained an independent relation to cognitive i m pairment also alter adjusting for those variables associated with mental decline in univariate models (GDS, IADL, and APACHE IU scores). CONCLUSIONS: The results of this study support the relationship between non rheumatic atrial fibrillation and impaired cognitive function. Independent of etiopathogenetic mechanisms (thromboembolic or hemodynamic hypotheses), prevention of cognitive impairment in older persons should take into accoun t the treatment of atrial fibrillation and its consequences.