Rapid Dementia Onset Linked to Atrial Fibrillation in Women

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July 7, 2023 – Women with a common heart rhythm problem called atrial fibrillation are more likely to develop dementia, and the severity of their dementia progresses more quickly for women than it does for men, according to a new study. 

One reason may be because women are at a high risk of being undiagnosed for atrial fibrillation, and may be experiencing tiny “silent strokes” that damage their brains a little bit at a time, the lead researcher said.

“Symptoms of atrial fibrillation in women are often ignored by healthcare providers or attributed to stress or anxiety so it can go undiagnosed for [a] long period of time, while men are more likely to be diagnosed and treated quickly,” said study author and Emory University associate professor of nursing Kathryn Wood, PhD, in a statement. “Being undiagnosed means not receiving oral anticoagulant medication to prevent blood clots and strokes caused by atrial fibrillation. These women may be having clots that go to small blood vessels in their brain, causing them to lose brain function gradually and develop cognitive impairment.”

The study, published last month in the Alzheimer’s Association journal Alzheimer’s & Dementia, included data from 43,630 people, of whom 4,593 had atrial fibrillation at the start of the study, and 39,037 did not. The average age of people in the study was 78.5 years old and 46% were women. Researchers looked at whether people were diagnosed with atrial fibrillation, whether they had cognitive impairment or the more severe diagnosis of dementia at the time of diagnosis, and also how rapidly the condition progressed.

Women with atrial fibrillation were three times more likely than men to be diagnosed with mild cognitive impairment or dementia. Women had a 26% increased risk of moving from normal cognitive function to mild cognitive function after an atrial fibrillation diagnosis, and an 89% increased risk of moving from mild cognitive function to dementia. The elevated risks were in comparison to men with atrial fibrillation, as well as compared to men and women without atrial fibrillation.

According to the CDC, an estimated 12 million people in the U.S. have atrial fibrillation, which sometimes has no symptoms at all but can include one or more of the following:

  • Irregular heartbeat
  • Heart palpitations (rapid, fluttering, or pounding)
  • Lightheadedness
  • Extreme fatigue
  • Shortness of breath
  • Chest pain

People with Afib have a fivefold higher risk of having a stroke. The CDC estimates that 1 in 7 strokes are caused by Afib. The irregular heartbeat means blood doesn’t flow well from the upper chambers of the heart to the lower chambers, and the problems can occur in brief episodes or permanently.

“Establishing ways to identify atrial fibrillation patients at the highest risk of cognitive decline and stroke will inform future interventions to prevent or slow the progression to cognitive impairment and dementia,” Wood said.