ATLANTA — Women with the common heart rhythm disorder atrial fibrillation (AFib) have three times the risk of developing Alzheimer’s disease, new research reveals. Furthermore, cognitive decline tends to progress about twice as fast in these women compared to men diagnosed with the same disorder.
“Symptoms of atrial fibrillation in women are often overlooked by health care providers or attributed to stress or anxiety, so it can go undiagnosed for a long period of time, while men are more likely to be diagnosed and treated quickly,” says study author Dr. Catherine Wood of Emory University.
“Being undiagnosed means not receiving oral anticoagulants to prevent blood clots and strokes caused by atrial fibrillation.”
Dr. Wood’s team analyzed data from 43,630 US adults participating in a dementia study over an average of four years. Participants had at least three annual clinic visits during which they undertook neuropsychological testing. Their cognitive health status was classified into one of three categories: normal cognition, mild cognitive impairment (MCI), or full dementia.
Dr. Wood suggests that these women may be experiencing clots that travel to small blood vessels in their brains. This process can lead to a gradual loss of brain function and subsequent cognitive impairment.
“These women may have clots that go into the small blood vessels in their brain, causing them to lose brain function gradually and develop cognitive impairment,” Dr. Wood continues in media release.
“The ESC guidelines for the care of patients with atrial fibrillation recommend oral anticoagulants for both women and men,” explains Dr. Wood. “However, we know that women are less likely to receive these drugs than men. This is another reason why women can have small, silent strokes that go unrecognized and damage brain tissue, leading to cognitive impairment.
Photo by geralt from PixabayThe research found that women with AFib were three times more likely to develop MCI and dementia, compared with odds ratios for men that were just over half that. Furthermore, these women faced a 21% increased risk of progression to a more severe stage of cognitive impairment compared to their heart-healthy peers.
Participants with the condition were also about 2.5 times more likely to progress from MCI to a form of dementia known as vascular dementia. In addition, they had a 17% higher chance of transitioning from normal cognition to MCI. However, associations between atrial fibrillation and faster cognitive decline were not statistically significant in men.
“Analyses show stronger associations between atrial fibrillation and cognitive decline in women compared to men. “Establishing ways to identify patients with atrial fibrillation at highest risk of cognitive decline and stroke will inform future interventions to prevent or slow the progression to cognitive impairment and dementia,” says Dr. Wood.
According to CDC, AFib will affect more than 12 million Americans by 2030. It occurs when the heart’s two upper chambers are out of sync, causing an abnormal heart rhythm. This, in turn, affects how well blood flows to the lower chambers of the heart, called the ventricles.
It can also be corrected by a simple procedure called catheter ablation. It uses radio frequency to burn small areas of tissue, causing faulty nerve messages. A fine tube is inserted into a vein in the leg and passed through vessels into the organ. Unfortunately, up to one in 10 patients may experience complications, including stroke, perforation of the heart muscle or dangerously low blood pressure. Not all respond, even after repeated attempts, and some cannot undergo surgery because of frailty or because of previous heart operations.
The findings were presented at ACNAP 2023Scientific Congress of the European Society of Cardiology.
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South West News Service writer Mark Waghorn contributed to this report.