Alzheimer hastalığında atriyal fibrilasyonun bilişsel gerileme ve kortikal atrofi üzerine etkisi

Year 2025, Volume: 8 Issue: 6, 1023 - 1029, 25.10.2025

Özlem Totuk , Hasan Can Güdek , Şevki Şahin

https://doi.org/10.32322/jhsm.1771038

Abstract

Amaç: Bu çalışmanın amacı, Alzheimer hastalığı (AH) olan bireylerde atriyal fibrilasyonun (AF) bilişsel işlev ve nöroradyolojik belirteçler üzerindeki etkisini değerlendirmektir.

Yöntem: Demans Polikliniği'nde toplam 800 hasta tarandı. Atriyal fibrilasyonu doğrulanmış 33 AH hastası çalışmaya dahil edildi; kontrol grubu olarak ise yaş, cinsiyet ve eğitim düzeyi açısından eşleştirilmiş, AF olmayan 31 AH hastası seçildi. Bilişsel işlev Mini Mental Durum Değerlendirme Testi (MMSE) ile değerlendirildi. Duygudurum semptomları Geriatrik Anksiyete Ölçeği ve Geriatrik Depresyon Ölçeği ile ölçüldü. Beyin MRG görüntüleri Fazekas, Mediyal Temporal Atrofi (MTA) ve Koedam skorlama sistemleriyle analiz edildi.

Bulgular: Altı ay sonunda, AF pozitif grubunda MMSE puanlarında anlamlı bir düşüş gözlendi; buna karşın AF negatif grubunda anlamlı bir değişiklik saptanmadı. Koedam skorları, AF pozitif grubunda anlamlı derecede daha yüksek bulundu ve bu durum daha ileri düzeyde kortikal atrofiye işaret etti. Regresyon analizleri, başlangıç MMSE puanlarına göre düzeltme yapıldığında AF’nin bilişsel performans üzerinde sınırda anlamlılıkta negatif bir etkisi olduğunu gösterdi.

Sonuç: AF, AH hastalarında bilişsel gerilemeyi hızlandırabilir ve daha belirgin kortikal atrofi ile ilişkilidir. Bu bulgular, söz konusu hasta grubunda bilişsel işlevlerin yakından izlenmesi ve kişiye özel tedavi stratejilerinin önemini vurgulamaktadır.

Keywords

Alzheimer hastalığı , atriyal fibrilasyon , bilişsel gerileme , kortikal atrofi , beyin görüntüleme

Impact of atrial fibrillation on cognitive decline and cortical atrophy in Alzheimer’s disease

Abstract

Aims: This study aimed to evaluate the impact of atrial fibrillation (AF) on cognitive function and neuroradiological markers in patients with Alzheimer’s disease (AD).
Methods: A total of 800 patients were screened at the Dementia Outpatient Clinic of Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital. Thirty-three AD patients with confirmed AF were included, alongside 31 age-, sex, and education-matched AD patients without AF as controls. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), while mood symptoms were evaluated with the Geriatric Anxiety Scale and the Geriatric Depression Scale. Brain MRI scans were analyzed using Fazekas, Medial Temporal Atrophy (MTA), and Koedam scores. Due to the modest sample size, this study is best interpreted as exploratory in nature.
Results: After six months, the AF-positive group exhibited a significant decline in MMSE scores, whereas the AF-negative group showed no significant change. Koedam scores were significantly higher in the AF-positive group, indicating more advanced cortical atrophy. Regression analysis revealed that AF had a borderline significant negative impact on cognitive performance after adjusting for baseline MMSE scores.
Conclusion: AF may accelerate cognitive decline and is associated with greater cortical atrophy in patients with AD. These findings suggest that close cognitive monitoring and individualized care strategies may be beneficial in this population, though further research is needed to confirm this.

Keywords

Alzheimer disease , atrial fibrillation , cognitive decline , cortical atrophy , neuroimaging

Ethical Statement

The study was approved by the Ethics Committee of the University of Health Sciences, Hamidiye Faculty of Medicine, Sancaktepe Şehit Prof. Dr. İlhan Varank SUAM (Date: 09.04.2025, Number: 107).

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