Dementia - just the word can strike fear into the hearts of aging Americans and their loved ones.
Along with an unprecedented worldwide increase in the population of elder Americans - to the point where fully 8.5 percent of the world's adults are now 65 or older - comes an increasing push to understand what causes dementia and how to remedy it.
Now, the results of a new study published on June 18, 2019, by the European Heart Journal are suggesting that atrial fibrillation, or a-fib, can increase the risk of dementia by up to 50 percent.
In other words, if an individual has been diagnosed with a-fib, their future risk of developing dementia increases by half. In this article, learn more details about the study findings and what treatments may reduce this risk in affected individuals.
A Working Definition of Dementia
The word "dementia" is well known, but its precise meaning still isn’t. Dementia is actually not just one condition. Rather, it is a set of symptoms that indicate declining brain and mind function.
Dementia can include Alzheimer's disease, post-stroke vascular dementia, frontotemporal disorder, mixed dementia, Lewy body dementia and other similar health conditions that induce a decline in thinking functions.
Dementia can also have multiple causes, of which stroke is the best-known. Thyroid disease and vitamin deficiencies are two known causes for dementia symptoms that are potentially reversible.
Symptoms of dementia can include impairment with concentration, communication, focus, reasoning, judgment, visual perception, short-term memory issues and similar issues. Symptoms tend to worsen as time passes.
A Working Definition of Atrial Fibrillation
Atrial fibrillation, or a-fib, is best understood as an ongoing condition of the heart that causes irregular heartbeat to occur.
Sometimes called abnormal heartbeat or simply arrhythmia, a-fib may affect as many as 6.1 million adults nationwide. Currently, fully nine percent of adults aged 65 or older are affected by a-fib.
Symptoms of a-fib can include heart palpitations, irregular heartbeat, lightheadedness, faintness, chest pressure or pain, shortness of breath, excessive fatigue, low blood pressure and similar symptoms.
Stroke is known to be a complicating factor for a-fib, as is the future development of cognitive difficulties, including dementia.
Prescribing blood thinner medication is one known treatment to help reduce risk of a-fib progressing to stroke or heart failure.
The Confirmed Link Between A-Fib and Dementia
Atrial fibrillation, or a-fib, was not previously associated with the onset of dementia symptoms. However, that has changed based on the European Heart Journal study, which followed 263,000 60+-year-old South Korean adult participants over a nine-year period.
All study participants were tested and found to be free of a-fib when the study launched in 2004. During the nine-year study period, approximately 10,400 of the participants were subsequently diagnosed with a-fib.
During the lifetime of the study, 24 percent of the participants with a-fib developed dementia. Contrast this with the rates of detention in the participants who did not develop a-fib. In this group, the rate of dementia was just 14 percent.
From this data, researchers concluded that individuals who are diagnosed with a-fib are 50 percent more likely to also be diagnosed with dementia in the future.
The Treatment That May Help Lessen Dementia Risk in A-Fib Patients
While the study results themselves are widely concerning, researchers were able to isolate one potentially beneficial treatment that may reverse the increased risk of dementia for a-fib patients.
The researchers also followed the treatment course for each a-fib affected study participants. What they found is encouraging for a-fib patients worried about developing dementia in the future.
Their a-fib affected research participants who were prescribed blood thinners or non-vitamin K anti-coagulant medications (direct acting oral anti-coagulants, or DOACs) subsequently experienced a 40 percent reduction in dementia risk.
Here, researchers also cited specific medications prescribed to their research participants diagnosed with a-fib, including Coumadin (warfarin), Pradaxa (dabigatran), Xarelto (rivaroxaban), Eliquis (apixaban) and Savaysa (edoxaban).
From this data, researchers have confidently stated that taking blood thinner-type medications can lessen the risk factor for future dementia among a-fib patients by as much as 40 percent.
Study Findings Apply to Both European and Western Adults
The researchers feel confident that their findings will be upheld based on the sheer size and duration of the study.
They also believe that the results will be found to translate to diverse populations, including both Western and European adults.
The researchers cited existing data and medical practices of prescribing blood thinners to stroke patients as supportive of their results as well. For example, patients who have experienced a major stroke or several minor or mini-strokes are often prescribed blood thinners to reduce the risk of additional strokes.
Since blood thinners can also minimize the risk of further incidents of a-fib, the researchers believe these findings will encourage more physicians to use this treatment approach for patients at risk of both stroke and dementia as a result of a-fib.
About the Study Researchers
Lead researchers on the European Heart Journal study linking a-fib with dementia include Laurence Epstein, M.D. and Marcin Kowalski, M.D.
Dr. Epstein heads up the electrophysiology department at Northwell Health in Manhasset, N.Y. Dr. Kowalski is the director of cardiac electrophysiology for Staten Island University Hospital in New York City, N.Y.
