Atrial fibrillation (AF) is associated with faster cognitive decline and an increased risk of dementia, especially in women, according to a new report in the journal Neurology.

Researchers from Sweden enrolled 2,685 people without dementia with an average age of 73 years. Of these, 9.1 per cent had AF at baseline. During the nine-year follow-up, 11.4 per cent developed AF and 14.9 per cent developed dementia.

The researchers could not distinguish between AF subtypes and might have missed asymptomatic AF. Nevertheless, AF was significantly associated with a faster annual decline in scores on the Mini-Mental State Examination, a 40 per cent increased risk of dementia from any cause and an 88 per cent increased risk of vascular and mixed dementia.

Women with AF were 46 per cent more likely to develop dementia than those without the arrhythmia. The 27 per cent increase in men was not statistically significant.

Based on an average follow-up of six years, AF patients who used anticoagulants were 60 per cent less likely to develop dementia. Assuming a cause and effect relationship, using anticoagulant drugs to treat all people with AF would have prevented approximately 54 per cent of the dementia cases.

Study author Chengxuan Qiu of the Karolinska Institute and Stockholm University, commented: “Additional efforts should be made to increase the use of blood thinners among older people with atrial fibrillation.”

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