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Atrial Fibrillation and Cognitive Disorders in Older People
Author(s) -
Sabatini Tony,
Frisoni Giovanni B.,
Barbisoni Piera,
Bellelli Giuseppe,
Rozzini Renzo,
Trabucchi Marco
Publication year - 2000
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2000.tb04695.x
Subject(s) - medicine , atrial fibrillation , activities of daily living , sinus rhythm , mini–mental state examination , univariate analysis , depression (economics) , comorbidity , cardiology , cognition , cognitive decline , physical therapy , multivariate analysis , cognitive impairment , dementia , psychiatry , disease , economics , macroeconomics
OBJECTIVES : To find a correlation between chronic non‐rheumatic atrial fibrillation (CNRAF) and cognitive impairment in a group of older, nondemented patients. SETTING : 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. J Am Geriatr Soc 48: 386–390, 2000 .