Women Could Have an Increased Risk of Developing MCI, Dementia with Atrial Fibrillation

New study findings published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association suggest that women with atrial fibrillation can have faster-progressing cognitive impairment and dementia than men with the same condition.

According to the study, atrial fibrillation is one of the most common heart rhythm disorders, defined as an irregular and rapid heart rhythm that can lead to blood clots in the heart. More than 40 million individuals worldwide are affected by atrial fibrillation and have an increased risk of experiencing a stroke compared with individuals who are healthy. Compared to men with the condition, women also experience worse symptoms and outcomes that could lead to death or more immobilizing strokes.

Senior woman with dementia | Image credit: pikselstock - stock.adobe.com

The study confirmed that dementia is also more common in women than men and women with atrial fibrillation have a higher risk of cognitive impairment and dementia. This could be because the heart condition has more than a 2-fold risk of silent strokes, which over time can lead to brain injuries and can only be stopped with oral anticoagulant medication, according to the study.

“Symptoms of atrial fibrillation in women are often ignored by health care providers or attributed to stress or anxiety, so it can go undiagnosed for long period of time, while men are more likely to be diagnosed and treated quickly,” study author Kathryn Wood, PhD, RN, FAHA, FAAN, of Emory University said in the press release. “Being undiagnosed means not receiving oral anticoagulant medication to prevent blood clots and strokes caused by atrial fibrillation. These women may be having clots that go to small blood vessels in their brain, causing them to lose brain function gradually and develop cognitive impairment.”

In the press release, the authors explained that this was the first study conducted using various data to conclude why women and more likely to develop these illnesses than men.

“[European Society of Cardiology] Guidelines for the care of patients with atrial fibrillation recommend oral anticoagulants for both women and men. However, we know that women are less likely to receive these medications than men. This is another reason why women may have small silent strokes that go unrecognized and damage brain tissue leading to cognitive impairment.,” Wood said in the press release.

In the study, investigators included 43,630 individuals from the National Alzheimer Coordinating Center (NACC). Of those, 4,593 had atrial fibrillation and 39,037 did not. The average age of the participants was 78.5 and 46% were women. In order to complete the study, the participants had to have 3 annual clinic visits where they were required to take a neuropsychological test that determined whether they were characterized as normal cognition, mild cognitive (MCI), or dementia.

“The researchers analyzed the associations between 1) atrial fibrillation and baseline cognitive diagnosis; and 2) atrial fibrillation and time to progression in cognitive diagnosis. The analyses were adjusted for factors that could influence the relationships including age, sex, race, education, body mass index, smoking, depression, hypertension, diabetes, high cholesterol, heart failure, stroke, and sleep apnea. Men and women with atrial fibrillation were compared to those without the condition and differences by gender were examined,” the authors wrote in the press release.

The study concluded that women with atrial fibrillation were 3 times more likely to have MCI or dementia than men. After a 4-year follow-up appointment, the women were classified as worse stages of MCI and dementia.

The findings suggest that in order to slow the production of MCI and dementia, more approaches to establishing the diagnoses for women can prevent the progression.

Reference:

Women with common heart rhythm disorder have faster cognitive decline than men. News release. EurekAlert!. June 23, 2023. Accessed June 29, 2023. https://www.eurekalert.org/news-releases/993243.