Effects of Atrial Fibrıllation on Cognitive Functions in Patients Between 65-75 Years of Age

Year 2024, , 170 - 177, 30.06.2024

Ece Yiğit , Dogac Oksen

https://doi.org/10.52827/hititmedj.1445822

Abstract

Objective: Atrial fibrillation (AF) is the most common arrhythmia in the elderly population and also the most common cause of ischemic stroke. Ischemic stroke is directly related to cognitive decline. The relationship between atrial fibrillation and cognitive decline has long been associated with stroke. This study aimed to reveal whether the mere presence of atrial fibrillation, independent of stroke, has negative effects on cognitive functions.
Material and Method: Male and female patients between the ages of 65 and 75 with no chronic diseases other than known hypertension were included in the study. They were divided into two groups according to electrocardiography findings: the group with newly diagnosed atrial fibrillation and the group with normal sinus rhythm (NSR). To evaluate cognitive functions, the Montreal Cognitive Assessment (MoCA) was applied to both groups and then the groups were compared in terms of scores.
Results: No statistically significant difference was observed between the groups in terms of age, patient characteristics, educational status, or laboratory findings. MoCA scores were significantly lower in the AF group than in the NSR group (p=0.001). Multivariable linear regression analysis demonstrated lower age and higher education status were independently associated with high MoCA scores (β: 3.392, 95% CI: 2.375 - 4.410, p<0.001 / β: -0.478, 95% CI: -0.664 - -0.292, p<0.001, respectively). In addition, AF was independently associated with low MoCA scores after adjustments by age and education status (β:-2.463, 95% CI: -3.448 - -1.478, p<0.001).
Conclusion: AF is a risk factor for cognitive decline regardless of the presence of ischemic stroke.

Keywords

Arrhythmia, Atrial fibrillation, Cognitive decline

65 - 75 Yaş Arası Hastalarda Atriyal Fibrilasyonun Kognitif Fonksiyonlar Üzerine Etkileri

Abstract

Amaç: Yaşlı popülasyonda en sık görülen aritmi olan atriyal fibrilasyon (AF), aynı zamanda iskemik inmenin de en sık nedenidir. İskemik inme bilişsel gerilemeyle doğrudan ilişkilidir. Atriyal fibrilasyon ile bilişsel gerileme arasındaki ilişki yıllardır inme ile ilişkilendirilmiştir. Bu çalışma, inmeden bağımsız olarak sadece atriyal fibrilasyon varlığının bilişsel işlevler üzerinde olumsuz etkilerinin olup olmadığını ortaya koymayı amaçlamıştır.
Gereç ve Yöntem: Çalışmaya bilinen hipertansiyon dışında kronik hastalığı olmayan, 65-75 yaş arası erkek ve kadın hastalar dahil edildi. Elektrokardiyografi bulgularına göre hastalar yeni tanı alan AF grubu ve normal sinüs ritmi (NSR) grubu olmak üzere ikiye ayrıldı. Bilişsel işlevleri değerlendirmek amacıyla her iki gruba da Montreal Bilişsel Değerlendirme (MoCA) uygulandı ve gruplar sonuçlar açısından karşılaştırıldı.
Bulgular: Gruplar arasında yaş, hasta özellikleri, eğitim durumu ve laboratuvar bulguları açısından istatistiksel olarak anlamlı fark yoktu. MoCA skoru AF grubunda NSR grubuna göre anlamlı derecede düşüktü (p=0,001). Çok değişkenli doğrusal regresyon analizi, düşük yaş ve yüksek eğitim durumunun bağımsız olarak yüksek MoCA puanıyla ilişkili olduğunu gösterdi (β: 3,392, %95 GA: 2,375- 4,410, p<0,001 / β: -0,478, %95 GA: -0,664 - -0,292, p<0,001, sırasıyla). Ayrıca AF, yaş ve eğitim durumundan bağımsız olarak düşük MoCA puanıyla ilişkili bulundu (β:-2,463, %95 GA: -3,448 - -1,478, p<0,001).
Sonuç: AF, iskemik inmenin varlığından bağımsız olarak bilişsel gerileme için bir risk faktörüdür.

Keywords

Aritmi, Atriyal fibrilasyon, Bilişsel gerileme

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