Atrial fibrillation and cognitive disorders in older people.
OBJECTIVE
To find a correlation between chronic nonrheumatic atrial fibrillation (CNRAF) and cognitive impairment in a group of older, nondemented patients.


METHODS
Acute Care Unit for the Elderly, Poliambulanza Hospital, Brescia (Italy).


METHODS
Two hundred fifty-five hospital in-patients older than 70 years (42 with CNRAF and 213 controls with normal sinus rhythm) were assessed by complete clinical history, physical examination, ECG, serum albumin levels, APACHE II score, mental status (Mini-Mental State Exam [MMSE] and Geriatric Depression Score [GDS]), functional status (Barthel Index and instrumental activities of daily living [IADL]), number of prescribed drugs, and comorbidity (Charlson Index).


RESULTS
The group of patients with CNRAF had MMSE scores significantly lower than that of the reference group with normal sinus rhythm. Chronic nonrheumatic atrial fibrillation retained an independent relation to cognitive impairment also after adjusting for those variables associated with mental decline in univariate models (GDS, IADL, and APACHE II scores).


CONCLUSIONS
The results of this study support the relationship between nonrheumatic atrial fibrillation and impaired cognitive function. Independent of etiopathogenetic mechanisms (thromboembolic or hemodynamic hypotheses), prevention of cognitive impairment in older persons should take into account the treatment of atrial fibrillation and its consequences.
Sabatini
T
T
Acute Care Unit for the Elderly, Poliambulanza Hospital, Brescia, Italy.
Frisoni
G B
GB
Barbisoni
P
P
Bellelli
G
G
Rozzini
R
R
Trabucchi
M
M
D018806:APACHE; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications*; D002908:Chronic Disease; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology*; D015897:Comorbidity; D005260:Female; D015577:Geriatric Assessment; D006760:Hospitalization; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D011159:Population Surveillance