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Mid-term changes in cognitive functions in patients with atrial fibrillation: a longitudinal analysis of the Swiss-AF cohort.
Wueest, Alexandra S; Zuber, Priska; Coslovsky, Michael; Rommers, Nikki; Rodondi, Nicolas; Gencer, Baris; Moschovitis, Giorgio; De Perna, Maria Luisa; Beer, Juerg H; Reichlin, Tobias; Krisai, Philipp; Springer, Anne; Conen, David; Stauber, Annina; Mueller, Andreas S; Paladini, Rebecca E; Kuhne, Michael; Osswald, Stefan; Monsch, Andreas U; Bonati, Leo H.
Afiliação
  • Wueest AS; University Department of Geriatric Medicine FELIX PLATTER, Memory Clinic, Basel, Switzerland.
  • Zuber P; Clinic for Anaesthesia, Intermediate Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, Switzerland.
  • Coslovsky M; Division of Cognitive Neuroscience, Faculty of Psychology, University of Basel, Basel, Switzerland.
  • Rommers N; Cardiology Division, Department of Medicine, University Hospital Basel, Basel, Switzerland.
  • Rodondi N; Cardiovascular Research Institute Basel (CRIB), Basel, Switzerland.
  • Gencer B; Department of Clinical Research, University of Basel, University Hospital Basel, Basel, Switzerland.
  • Moschovitis G; Department of Clinical Research, University of Basel, University Hospital Basel, Basel, Switzerland.
  • De Perna ML; Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
  • Beer JH; Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Reichlin T; Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
  • Krisai P; Division of Cardiology, Ente Ospedaliero Cantonale (EOC), Cardiocentro Ticino Institute, Regional Hospital of Lugano, Lugano, Switzerland.
  • Springer A; Division of Cardiology, Ente Ospedaliero Cantonale (EOC), Cardiocentro Ticino Institute, Regional Hospital of Lugano, Lugano, Switzerland.
  • Conen D; Department of Medicine, Cantonal Hospital of Baden and Molecular Cardiology, University Hospital of Zürich, Zürich, Switzerland.
  • Stauber A; Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Mueller AS; Cardiology Division, Department of Medicine, University Hospital Basel, Basel, Switzerland.
  • Paladini RE; Cardiovascular Research Institute Basel (CRIB), Basel, Switzerland.
  • Kuhne M; Cardiovascular Research Institute Basel (CRIB), Basel, Switzerland.
  • Osswald S; Department of Clinical Research, University of Basel, University Hospital Basel, Basel, Switzerland.
  • Monsch AU; Population Health Research Institute, McMaster University, Hamilton, ON, Canada.
  • Bonati LH; Department of Cardiology, Triemli Hospital Zürich, Zürich, Switzerland.
Front Cardiovasc Med ; 10: 1212587, 2023.
Article em En | MEDLINE | ID: mdl-37600058
ABSTRACT

Background:

Longitudinal association studies of atrial fibrillation (AF) and cognitive functions have shown an unclear role of AF-type and often differ in methodological aspects. We therefore aim to investigate longitudinal changes in cognitive functions in association with AF-type (non-paroxysmal vs. paroxysmal) and comorbidities in the Swiss-AF cohort.

Methods:

Seven cognitive measures were administered up to five times between 2014 and 2022. Age-education standardized scores were calculated and association between longitudinal change in scores and baseline AF-type investigated using linear mixed-effects models. Associations between AF-type and time to cognitive drop, an observed score of at least one standard deviation below individual's age-education standardized cognitive scores at baseline, were studied using Cox proportional hazard models of each cognitive test, censoring patients at their last measurement. Models were adjusted for baseline covariates.

Results:

2,415 AF patients (mean age 73.2 years; 1,080 paroxysmal, 1,335 non-paroxysmal AF) participated in this Swiss multicenter prospective cohort study. Mean cognitive scores increased longitudinally (median follow-up 3.97 years). Non-paroxysmal AF patients showed smaller longitudinal increases in Digit Symbol Substitution Test (DSST), Cognitive Construct Score (CoCo)and Trail Making Test part B (TMT-B) scores vs. paroxysmal AF patients. Diabetes, history of stroke/TIA and depression were associated with worse performance on all cognitive tests. No differences in time to cognitive drop were observed between AF-types in any cognitive test.

Conclusion:

This study indicated preserved cognitive functioning in AF patients, best explained by practice effects. Smaller practice effects were found in non-paroxysmal AF patients in the DSST, TMT-B and the CoCo and could indicate a marker of subtle cognitive decline. As diabetes, history of stroke/TIA and depression-but not AF-type-were associated with cognitive drop, more attention should be given to risk factors and underlying mechanisms of AF.
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Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Ano de publicação: 2023 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Ano de publicação: 2023 Tipo de documento: Article