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

Мұқаба

Дәйексөз келтіру

Толық мәтін

Ашық рұқсат Ашық рұқсат
Рұқсат жабық Рұқсат берілді
Рұқсат жабық Рұқсат ақылы немесе тек жазылушылар үшін

Аннотация

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.

Толық мәтін

Рұқсат жабық

Авторлар туралы

I. Orlova

Russian Medical Academy of Continuous Professional Education; E.O. Mukhin City Clinical Hospital

Email: ostroumova.olga@mail.ru
ORCID iD: 0000-0002-7745-3628
Ресей, Moscow; Moscow

S. Batyukina

Russian Medical Academy of Continuous Professional Education

Email: ostroumova.olga@mail.ru
ORCID iD: 0000-0003-1316-7654
Ресей, Moscow

A. Kochetkov

Russian Medical Academy of Continuous Professional Education

Email: ostroumova.olga@mail.ru
ORCID iD: 0000-0001-5801-3742
SPIN-код: 9212-6010
Ресей, Moscow

G. Piksina

E.O. Mukhin City Clinical Hospital

Email: ostroumova.olga@mail.ru
ORCID iD: 0000-0003-2114-1227
Ресей, Moscow

N. Plotnikova

Russian Medical Academy of Continuous Professional Education

Email: ostroumova.olga@mail.ru
ORCID iD: 0000-0001-5454-9339
Ресей, Moscow

Olga Ostroumova

Russian Medical Academy of Continuous Professional Education; I.M. Sechenov First Moscow State Medical University (Sechenov University)

Хат алмасуға жауапты Автор.
Email: ostroumova.olga@mail.ru
ORCID iD: 0000-0002-0795-8225
SPIN-код: 3910-6585

Dr. Sci. (Med.), Professor, Head of the Department of Therapy and Polymorbid Pathology n.a. Acad. M.S. Vovsin, Professor at the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases

Ресей, Moscow; Moscow

Әдебиет тізімі

  1. Ott A., Breteler M.M., de Bruyne M.C., et al. Atrial fibrillation and dementia in a population-based study. The Rotterdam Study. Stroke. 1997;28(2):316–21. doi: 10.1161/01.STR.28.2.316.
  2. Krijthe B.P., Kunst A., Benjamin E.J., et al. Projections on the number of individuals with atrial fibrillation in the European Union, from 2000 to 2060. Eur Heart J. 2013;34(35):2746–51. doi: 10.1093/eurheartj/eht280.
  3. Wong C.X., Brown A., Tse H.-F., et al. Epidemiology of atrial fibrillation: the Australian and Asia-Pacific perspective. Heart Lung Circ. 2017;26(9):870–79. doi: 10.1016/j.hlc.2017.05.120.
  4. Chander R.J., Lim L., Handa S., et al. Atrial fibrillation is independently associated with cognitive impairment after ischemic stroke. J Alzheimers Dis. 2017;60(3):867–75. doi: 10.3233/JAD-170313.
  5. Douiri A., McKevitt C., Emmett E.S., et al. Long-term effects of secondary prevention on cognitive function in stroke patients. Circulation. 2013;128(12):1341–48. doi: 10.1161/CIRCULATIONAHA.113.002236.
  6. Gorelick P.B., Scuteri A., Black S.E., et al. Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42(9):2672–713. doi: 10.1161/STR.0b013e3182299496.
  7. Knecht S., Oelschlager C., Duning T., et al. Atrial fibrillation in stroke-free patients is associated with memory impairment and hippocampal atrophy. Eur Heart J. 2008;29(17):2125–32. doi: 10.1093/eurheartj/ehn341.
  8. Chen L.Y., Agarwal S.K., Norby F.L., et al. Persistent but not Paroxysmal Atrial Fibrillation Is Independently Associated With Lower Cognitive Function: ARIC Study. J Am Coll Cardiol. 2016;67(11):1379–80. doi: 10.1016/j.jacc.2015.11.064.
  9. Nasreddine Z.S., Phillips N.A., Bedirian V., et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695–99. doi: 10.1111/j.1532-5415.2005.53221.x.
  10. Folstein M.F., Folstein S.E., McHugh P.R. «Mini-mental state». A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–98. doi: 10.1016/0022-3956(75)90026-6.
  11. Strauss E. A compendium of neuropsychological tests: Administration, Norms, and Commentary. 3d edition. Oxford: Oxford University Press, 2006. 1240 p.
  12. Morris J.C., Heyman A., Mohs R.C., et al. The Consortium to Establish a Registry for Alzheimer’s Disease (CERAD). Part I. Clinical and neuropsychological assessment of Alzheimer’s disease. Neurology. 1989;39(9):1159–65. doi: 10.1212/wnl.39.9.1159.
  13. Koh Y.H., Lew L.Z.W., Franke K.B., et al. Predictive role of atrial fibrillation in cognitive decline: a systematic review and meta-analysis of 2.8 million individuals. Europace. 2022;24(8):1229–39. doi: 10.1093/europace/euac003.
  14. Dublin S., Anderson M.L., Haneuse S.J., et al. Atrial fibrillation and risk of dementia: a prospective cohort study. J Am Geriatr Soc. 2011;59(8):1369–75. doi: 10.1111/j.1532-5415.2011.03508.x.
  15. Madhavan M., Graff-Radford J., Piccini J.P., et al. Cognitive dysfunction in atrial fibrillation. Nat. Rev. Cardiol. 2018;15(12):744–56. doi: 10.1038/s41569-018-0075-z.
  16. Zhang C., Gu Z.C., Shen L., et al. Non-vitamin K Antagonist Oral Anticoagulants and Cognitive Impairment in Atrial Fibrillation: Insights From the Meta-Analysis of Over 90,000 Patients of Randomized Controlled Trials and Real-World Studies. Front Aging Neurosci. 2018;2(10):258. doi: 10.3389/fnagi.2018.00258.
  17. Захаров В.В., Вахнина Н.В., Парфенов В.А. Когнитивные нарушения и их лечение при артериальной гипертензии. Медицинский совет. 2017;(Suppl. 1):6–12. [Zakharov V.V., Vakhnina N.V., Parfenov V.A. Cognitive disorders and their treatment in hypertension. Med Council. 2017; (Suppl. 1):6–12. (In Russ.)]. doi: 10.21518/2079-701X-2017-0-6-12.
  18. Graff-Radford J., Madhavan M., Vemuri P., et al. Atrial fibrillation, cognitive impairment, and neuroimaging. Alzheimers Dement. 2016;12(4):391–98. doi: 10.1016/j.jalz.2015.08.164.
  19. Gardarsdottir M., Sigurdsson S., Aspelund T., et al. Atrial fibrillation is associated with decreased total cerebral blood flow and brain perfusion. Europace. 2018;20(8):1252–58. doi: 10.1093/europace/eux220.
  20. Akoudad S., Wolters F.J., Viswanathan A., et al. Association of Cerebral Microbleeds With Cognitive Decline and Dementia. JAMA. Neurol. 2016;73(8):934–43. doi: 10.1001/jamaneurol.2016.1017.
  21. Wilson D., Jager H.R., Werring D.J. Anticoagulation for Atrial Fibrillation in Patients with Cerebral Microbleeds. Curr Atheroscler Rep. 2015;17(8):47. doi: 10.1007/s11883-015-0524-7.
  22. Hu Y.F., Chen Y.J., Lin Y.J., et al. Inflammation and the pathogenesis of atrial fibrillation. Nat Rev Cardiol. 2015;12(4):230–43. doi: 10.1038/nrcardio.2015.2.
  23. Li J., Solus J., Chen Q., et al. Role of inflammation and oxidative stress in atrial fibrillation. Heart Rhythm. 2010;7(4):438–44. doi: 10.1016/j.hrthm.2009.12.009.
  24. Когнитивные расстройства у пациентов пожилого и старческого возраста. Клинические рекомендации Минздрав РФ. Год утверждения: 2020. [Cognitive disorders in elderly and senile patients. Clinical recommendations of the Ministry of Health of the Russian Federation. 2020. (In Russ.)].
  25. Gaita F., Corsinovi L., Anselmino M., et al. Prevalence of silent cerebral ischemia in paroxys- mal and persistent atrial fibrillation and correlation with cognitive function. J Am Coll Cardiol. 2013;62(21):1990–97. doi: 10.1016/j.jacc.2013.05.074.
  26. Randolph C., Tierney M.C., Mohr E., et al. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS): preliminary clinical validity. J Clin Exp Neuropsychol. 1998;20(3):310–19. doi: 10.1076/jcen.20.3.310.823.

Қосымша файлдар

Қосымша файлдар
Әрекет
1. JATS XML
Жүктеу

© Bionika Media, 2024

Осы сайт cookie-файлдарды пайдаланады

Біздің сайтты пайдалануды жалғастыра отырып, сіз сайттың дұрыс жұмыс істеуін қамтамасыз ететін cookie файлдарын өңдеуге келісім бересіз.< / br>< / br>cookie файлдары туралы< / a>