State of cognitive functions in patients with various forms of atrial fibrillation

Orlova I.Yu., Batyukina S.V., Kochetkov A.I., Piksina G.F., Plotnikova N.A., Ostroumova O.D.

1) Russian Medical Academy of Continuous Professional Education, Moscow, Russia; 2) E.O. Mukhin City Clinical Hospital, Moscow, Russia; 3) I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

Background. Atrial fibrillation (AF) is a risk factor for cognitive impairment (CI) and dementia. However, the relationship between various forms of AF and CI remains poorly understood.
Objective. Comparison of the cognitive status of patients with various forms of AF and patients without AF.
Methods. The study included patients with various forms of AF: 70 (38.7%) patients with paroxysmal AF (73 [64.75; 76.5]), 54 (29.8%) with persistent or permanent forms (78.5 [68; 83]) and the control group – 57 (31.5%) patients without AF (75 [68; 81]). All patients underwent a study of cognitive functions using the Montreal Cognitive Assessment Scale (MoCA), Mini-Mental State Examination (MMSE), Verbal Association Test (literal/letter and categorical/animal associations), and 10-word memory test.
Results. Among patients with permanent and persistent forms of AF predominated those who scored the minimum number of points (≤24 points) when performing the MMSE: 13 (24.7%) versus 6 (8.4%), P=0.023, and the minimum number of points (10 –17 points) when performing the MoCA: 11 (20.9%) versus 4 (5.6%), P=0.023). They named fewer associations as literal: 9 [6; 11] versus 11 [7.5; 13.0], P=0.008, and categorical: 15 [11.25; 18] versus 17 [13; 21], P=0.046, and performed worse on the 10-word memorization test (immediate recall – 2.5 [0.25; 4.0] versus 3 [2.0; 4.5] words; P=0.043). Patients with permanent and persistent forms of AF compared to the control group (without AF) had worse cognitive function when tested on all neuropsychological tests. Compared to the control group (without AF), patients with paroxysmal AF named a larger number of words in the categorical association test: 17 [13; 21] versus 11 [9.5; 12] words (P=0.001) and fewer in the literal association test: 11 [7.5;13.0] versus 12 [10; 13], P=0.049; performed worse on the 10-word memorization test (immediate recall: 3 [2.0; 4.5] vs. 4 [3; 5] P=0.020.
Conclusion. The results obtained indicated an unfavorable effect of any form of AF on the cognitive functions of patients, with more pronounced CIs observed in patients with permanent and persistent forms of AF compared to both patients with paroxysmal AF and patients without AF.

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About the Authors

Corresponding author: Olga D. Ostroumova, Dr. Sci. (Med.), Professor, Head of the Department of Therapy and Polymorbid Pathology n.a. Acad. 
M.S. Vovsi, Russian Medical Academy of Continuous Professional Education; Professor at the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; ostroumova.olga@mail.ru

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