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To the Editor: In the clinic, atrial fibrillation (AF) is one of the most common types of arrhythmia encountered, and its burden and prevalence on the health‐care system are still on the rise. Over the past 50 years, AF incidence has increased by roughly 350.0%.[1] In a review from the Global Burden of Disease study, it was estimated that the worldwide prevalence of AF is 596.2 or 373.1/100,000 men or women. The Incidence of AF significantly increased with age.[2] Approximately 1% of AF patients are <60 years old, up to 12% of AF patients are in the 75–84 years age range and the AF prevalence is even higher in patients that are 80 years or older. Dementia is a disabling disease of the brain that characterized by impairments in memory and other cognitive functions. It can seriously affect human life. Worldwide, an estimated 33 million elderly individuals suffer from dementia, and this number is expected to reach 81.1 million by 2040. It is obvious that cognitive function deteriorates naturally with the aging of the body, but AF could accelerate the pace. According to some systematic reviews and meta‐analysis, AF can increase the risk of dementia by 40%. For the elder individuals, who are more than 75 years old, their dementia usually resulting from cerebrovascular lesions and neurodegeneration. While for the middle age individuals who are 40–59 years old, the advent of dementia is derived from cardiovascular disease. AF increases the risk of stroke, heart failure, and mortality. However, AF may also increase the risk of dementia, given the mutual vascular risk factors, such as smoking, hypertension, high cholesterol, diabetes mellitus, advancing age, chronic kidney disease, vascular disease, heart failure, inactivity/low activity, genetics, sleep apnea, and alcohol consumption.[3,4] The term “cardiogenic dementia” was first introduced more than 40 years ago to support a possible link between AF and cognitive impairment. It was not until recently that demonstrated AF is an independent risk factor of cognitive impairment and may increase the risk of dementia through several mechanisms, including cerebral hypoperfusion, thromboembolism (including both stroke and subclinical cerebral infarcts), inflammation, anticoagulation cerebral micro‐bleeds, and neuronal function impairment. Therefore, strategies that control the development of AF and promote cardiovascular health may help delay the onset of dementia. Traditional AF treatment involves anticoagulation, rhythm, and rate control. Thus, by understanding the potential relationship between AF and dementia, novel approaches may be proposed for future AF management.

Study Progress of the Influence of Atrial Fibrillation Treatment on Dementia