New evidence from the latest studies indicates that patients above 40 with atrial fibrillation are at risk of developing dementia. In atrial fibrillation, the upper chamber of the heart beats erratically, resulting in abnormal heart rhythm and reduced blood flow. The heart’s ineffective pumping leads to blood clots, which can further result in a stroke and dementia (cognitive decline).
How Atrial Fibrillation Affects Brain
Studies have confirmed that the reduced blood flow caused by atrial fibrillation has an impact on the brain in a number of ways. The beat-by-beat differences in the blood flow to the brain adversely affects brain function. The abnormal heartbeat leads to the pooling of blood in the heart, which creates clots. These clots tend to move to the brain and subsequently block the blood vessels, thereby having a more subtle impact on cognition.
It is possible to detect the clots in the blood vessels initially from symptoms like sudden and small strokes, which may go unnoticed and undetected by the patient; however, as time passes, such activities can have increasingly adverse impacts on cognitive abilities. The damage to the brain can increase, leading to dementia.
The way atrial fibrillation changes the blood flow through the body is another means by which it causes brain damage. It interrupts the blood-brain barricade. This is a membrane that isolates blood from cerebrospinal fluid. Moreover, it filters blood that enters and exits the brain and to the spinal cord. The interruption induces neuro-specific molecules to enter the bloodstream, thereby leading to brain damage and cognition decline.
Atrial Fibrillation Linked to Dementia
Scientists at the Stockholm University, one of Europe’s top centers for higher education and research in science, and Karolinska Institute, one of the world’s leading medical universities, carried out a survey1 in which they gathered data of 2685 participants above the age of 73. These participants were monitored for a period of six years. In the beginning, none of the participants had dementia, but with age, 9% of them were diagnosed with atrial fibrillation. During the follow-up period, 15% of them were diagnosed with dementia. The study determined that aging people with atrial fibrillation had a 40% higher risk of developing dementia when compared to those without it. It also established that patients with atrial fibrillation who were administered with blood thinners to avoid blood clots were able to cancel out the risk of developing dementia when compared to the patients who were not on medication.
Benefits of Anticoagulants
In addition to protecting patients from major strokes, anticoagulants or blood thinners also protect them from long-term cognitive decline. However, they should be administered in moderate amounts and as prescribed by a doctor since some studies even signify that high dosage of blood thinning medication can lead to micro-bleeds in the brain. Treatment strategies must be adjusted regularly to guarantee that the dosage of blood thinner is adequate, thus protecting the brain and heart of the affected individual.
1. J Alzheimers Dis. 2018;61(3):1119-1128. doi: 10.3233/JAD-170575.
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