ATLANTIS — Women with a common heart rhythm disorder, atrial fibrillation (AFib), are three times more likely to develop Alzheimer’s disease, new research reveals. Additionally, cognitive decline tends to progress about twice as fast in these women as in 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 they may go undiagnosed for a long time, while men are more rapidly diagnosed and treated,” says study author Dr. Kathryn Wood. from Emory University.
“Not being diagnosed means not receiving oral anticoagulants to prevent blood clots and strokes caused by atrial fibrillation.”
Dr. Wood’s team analyzed data from 43,630 American 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-blown dementia.
Dr. Wood speculates that these women may have clots traveling to small blood vessels in their brains. This process could lead to progressive loss of brain function and consequent cognitive impairment.
“These women may have clots that go into small blood vessels in their brains, causing them to gradually lose brain function and develop cognitive impairment,” Dr. Wood continued in a press release.
“The ESC guidelines for the care of patients with atrial fibrillation recommend oral anticoagulants for both women and men,” says 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.
The research found that women with atrial fibrillation were three times more likely to develop MCI and dementia, compared to the odds ratios in men, which were just over half. Additionally, these women faced a 21% increased risk of progressing to a more severe stage of cognitive impairment compared to their heart-healthy peers.
Participants with this condition were also about 2.5 times more likely to progress from MCI to a form of dementia known as vascular dementia. Additionally, they were 17% more likely to switch from normal cognition to MCI. However, associations between atrial fibrillation and more rapid cognitive decline were not statistically significant in men.
“The analyzes indicate stronger associations between atrial fibrillation and decline in cognitive function in women compared to men. Establishing ways to identify patients with atrial fibrillation most at risk for cognitive decline and stroke will inform future interventions aimed at preventing or slowing progression to cognitive impairment and dementia,” says Dr Wood. .
According to the CDC, atrial fibrillation will affect more than 12 million Americans by 2030. It occurs when the two upper chambers of the heart are out of sync, causing an abnormal heart rhythm. This, in turn, affects the quality of blood flow to the lower chambers of the heart, called the ventricles.
It can also be repaired with a simple procedure called catheter ablation. It uses radio frequency to burn small areas of tissue causing faulty nerve messages. A thin tube is inserted into a vein in the leg and threaded through the vessels into the organ. Unfortunately, up to one in 10 patients may suffer complications such as stroke, heart muscle perforation or dangerously low blood pressure. Not all of them respond, even after several attempts, and some cannot be operated on due to their fragility or previous heart operations.
The results were presented at ACNAP 2023, a scientific congress of the European Society of Cardiology.
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South West News Service writer Mark Waghorn contributed to this report.