Women with cardiac rhythm problems have faster cognitive deterioration than males: Study
According to analysis introduced at ACNAP 2023, a scientific congress of the European Society of Cardiology (ESC)1 and revealed in Alzheimer’s and Dementia: The Journal of the Alzheimer’s Association, girls with atrial fibrillation progress extra shortly to cognitive impairment and dementia than males with the center rhythm situation.
“Symptoms of atrial fibrillation in women are often ignored by healthcare 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,” mentioned research creator Dr. Kathryn Wood of Emory University, Atlanta, US. “Being undiagnosed means not receiving oral anticoagulant remedy to forestall blood clots and strokes attributable to atrial fibrillation. These girls could also be having clots that go to small blood vessels of their mind, inflicting them to lose mind operate progressively and develop cognitive impairment.”
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“ESC Guidelines for the care of patients with atrial fibrillation recommend oral anticoagulants for both women and men,” continued Dr. Wood.2 “However, we know that women are less likely to receive these medications than men.3,4 This is another reason why women may have small silent strokes that go unrecognised and damage brain tissue leading to cognitive impairment.”
Atrial fibrillation is the most typical coronary heart rhythm dysfunction, affecting greater than 40 million individuals worldwide.2 People with this situation have a five-fold elevated danger of stroke in contrast with their wholesome friends. Women have extra atrial fibrillation signs than males and worse outcomes from the dysfunction, with a better danger of demise and extra disabling strokes.2,5,6
Dementia is extra frequent in girls than males.7 Atrial fibrillation is related to a better danger for cognitive impairment and dementia, probably as a result of the situation is linked with a greater than two-fold danger of silent strokes.8 The accumulation of silent strokes and the related mind accidents over time might contribute to cognitive impairment. Stroke prevention with oral anticoagulant medicine is the principle precedence in managing atrial fibrillation and will scale back the chance of dementia.
This was the primary longitudinal research to make use of multicentre information to look at intercourse variations within the prevalence of cognitive illness in sufferers with atrial fibrillation and the trajectory to dementia. The research included 43,630 members of the National Alzheimer’s Coordinating Center (NACC) cohort which has enrolled adults from the US basic inhabitants since 1984. Of these, 4,593 (11%) had atrial fibrillation at baseline and 39,037 (89%) didn’t. The common age was 78.5 years and 46% had been girls. To be included on this research, members had been required to have not less than three annual clinic visits throughout which they took neuropsychological checks and had been categorised as having regular cognition, delicate cognitive impairment (MCI) or dementia.
The researchers analysed the associations between 1) atrial fibrillation and baseline cognitive prognosis; and a couple of) atrial fibrillation and time to development in cognitive prognosis. The analyses had been adjusted for elements that might affect the relationships together with age, intercourse, race, schooling, physique mass index, smoking, despair, hypertension, diabetes, excessive ldl cholesterol, coronary heart failure, stroke, and sleep apnoea. Men and ladies with atrial fibrillation had been in comparison with these with out the situation and variations by gender had been examined.
Women with atrial fibrillation had been thrice extra more likely to have MCI and dementia at baseline in comparison with girls with out atrial fibrillation, with odds ratios of three.43 (MCI) and three.00 (dementia). The odds ratios for males had been 1.73 and 1.60, respectively, however neither affiliation was statistically important in males.
During a median follow-up of 4 years, 30% of members progressed to a worse stage of cognitive impairment and 21% developed dementia. Women with atrial fibrillation had a better danger of progressing to a worse stage of cognitive impairment in comparison with girls with out atrial fibrillation, with a hazard ratio (HR) of 1.21. Regarding development to every stage, in comparison with girls with out atrial fibrillation, girls with the situation had been extra more likely to transition from regular cognition to MCI (HR 1.17) and from MCI to vascular dementia (HR 2.57). The associations between atrial fibrillation and extra fast cognition decline weren’t statistically important in males.
Dr Wood mentioned: “The analyses indicate stronger associations between atrial fibrillation and declining cognitive function in women compared with men. Establishing ways to identify atrial fibrillation patients at the highest risk of cognitive decline and stroke will inform future interventions to prevent or slow the progression to cognitive impairment and dementia.”
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