(Press-News.org) Edinburgh, UK – 23 June 2023: Women with atrial fibrillation progress more rapidly to cognitive impairment and dementia than men with the heart rhythm condition, according to research presented today at ACNAP 2023, a scientific congress of the European Society of Cardiology (ESC)1 and published in Alzheimer's & Dementia: The Journal of the Alzheimer's Association.
“Symptoms of atrial fibrillation in women are often ignored by healthcare providers or attributed to stress or anxiety so it can go undiagnosed for long period of time, while men are more likely to be diagnosed and treated quickly,” said study author Dr. Kathryn Wood of Emory University, Atlanta, US. “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.”
“ESC Guidelines for the care of patients with atrial fibrillation recommend oral anticoagulants for both women and men,” continued Dr. Wood.2 “However, we know that women are less likely to receive these medications than men.3,4 This is another reason why women may have small silent strokes that go unrecognised and damage brain tissue leading to cognitive impairment.”
Atrial fibrillation is the most common heart rhythm disorder, affecting more than 40 million people worldwide.2 People with this condition have a five-fold increased risk of stroke compared with their healthy peers. Women have more atrial fibrillation symptoms than men and worse outcomes from the disorder, with a higher risk of death and more disabling strokes.2,5,6
Dementia is more common in women than men.7 Atrial fibrillation is associated with a higher risk for cognitive impairment and dementia, possibly because the condition is linked with a more than two-fold risk of silent strokes.8 The accumulation of silent strokes and the associated brain injuries over time may contribute to cognitive impairment. Stroke prevention with oral anticoagulant drugs is the main priority in the management of atrial fibrillation and may reduce the risk of dementia.
This was the first longitudinal study to use multicentre data to examine sex differences in the prevalence of cognitive disease in patients with atrial fibrillation and the trajectory to dementia. The study included 43,630 participants of the National Alzheimer’s Coordinating Center (NACC) cohort which has enrolled adults from the US general population since 1984. Of those, 4,593 (11%) had atrial fibrillation at baseline and 39,037 (89%) did not. The average age was 78.5 years and 46% were women. To be included in this study, participants were required to have at least three annual clinic visits during which they took neuropsychological tests and were categorised as normal cognition, mild cognitive impairment (MCI) or dementia.
The researchers analysed the associations between 1) atrial fibrillation and baseline cognitive diagnosis; and 2) atrial fibrillation and time to progression in cognitive diagnosis. The analyses were adjusted for factors that could influence the relationships including age, sex, race, education, body mass index, smoking, depression, hypertension, diabetes, high cholesterol, heart failure, stroke, and sleep apnoea. Men and women with atrial fibrillation were compared to those without the condition and differences by gender were examined.
Women with atrial fibrillation were three times more likely to have MCI and dementia at baseline compared to women without atrial fibrillation, with odds ratios of 3.43 (MCI) and 3.00 (dementia). The odds ratios for men were 1.73 and 1.60, respectively, but neither association was statistically significant in men.
During a median follow-up of four years, 30% of participants progressed to a worse stage of cognitive impairment and 21% developed dementia. Women with atrial fibrillation had a higher risk of progressing to a worse stage of cognitive impairment compared to women without atrial fibrillation, with a hazard ratio (HR) of 1.21. Regarding progression to each stage, compared to women without atrial fibrillation, women with the condition were more likely to transition from normal cognition to MCI (HR 1.17) and from MCI to vascular dementia (HR 2.57). The associations between atrial fibrillation and more rapid cognition decline were not statistically significant in men.
Dr. Wood said: “The analyses indicate stronger associations between atrial fibrillation and declining cognitive function in women compared with men. 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.”
ENDS
Authors: ESC Press Office
Tel: +33 (0)489 872 075
Email: press@escardio.org
Follow us on Twitter @ESCardioNews
Notes to editor
Funding: This two-year study was funded by the National Institutes of Health and National Institute on Aging (Grant number R03AG067207).
Disclosures: There were no conflicts of interest among any of the co-authors.
References and notes
1The abstract ‘Sex differences in atrial fibrillation and progression to dementia’ will be presented during the session ‘Research aimed to advance patient well being’ which takes place on 23 June at 10:45 CEST in the ACNAP Scientific Corner.
2Hindricks G, Potpara T, Nikolaos Dagres N, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2021;42:373–498.
3Yong CM, Tremmel JA, Lansberg MG, et al. Sex differences in oral anticoagulation and outcomes of stroke and intracranial bleeding in newly diagnosed atrial fibrillation. J Am Heart Assoc. 2020;9:e015689.
4Thompson LE, Maddox TM, Lei L, et al. Sex differences in the use of oral anticoagulants for atrial fibrillation: a report from the National Cardiovascular Data Registry (NCDR®) PINNACLE Registry. J Am Heart Assoc. 2017;6:e005801.
5Blum S, Muff C, Aeschbacher S, et al. Prospective assessment of sex-related differences in symptom status and health perception among patients with atrial fibrillation. J Am Heart Assoc. 2017;6:e005401.
6Linde C, Bongiorni MG, Birgersdotter-Green U, et al. Sex differences in cardiac arrhythmia: a consensus document of the European Heart Rhythm Association, endorsed by the Heart Rhythm Society and Asia Pacific Heart Rhythm Society. Europace. 2018;20:1565–1565ao.
7Prince M, Bryce R, Albanese E, et al. The global prevalence of dementia: a systematic review and meta-analysis. Alzheimers Dement. 2013;9:63–75.e2.
8Dagres N, Chao TF, Fenelon G, et al. European Heart Rhythm Association (EHRA)/Heart Rhythm Society (HRS)/Asia Pacific Heart Rhythm Society (APHRS)/Latin American Heart Rhythm Society (LAHRS) expert consensus on arrhythmias and cognitive function: what is the best practice? Europace. 2018;20:1399–1421.
About ACNAP 2023 #ACNAP2023
ACNAP 2023 is the annual conference of the Association of Cardiovascular Nursing and Allied Professions (ACNAP) of the European Society of Cardiology (ESC).
About the Association of Cardiovascular Nursing & Allied Professions
The mission of the Association of Cardiovascular Nursing & Allied Professions (ACNAP) is to support nurses and allied health professionals throughout Europe to deliver the best possible care to patients with cardiovascular disease and their families.
About the European Society of Cardiology
The European Society of Cardiology brings together health care professionals from more than 150 countries, working to advance cardiovascular medicine and help people lead longer, healthier lives.
Information for journalists about registration for ACNAP 2023
ACNAP 2023 takes place 23 and 24 June at the Edinburgh International Conference Centre (EICC), UK. Explore the scientific programme.
Free registration applies to accredited press.
Credentials: A valid press card or appropriate letter of assignment with proof of three recent published articles. Read the ESC media and embargo policy.
The ESC Press Office will verify the documents and confirm by email that your press accreditation is valid.
The ESC Press Office decision is final regarding all press registration requests. END
Women with common heart rhythm disorder have faster cognitive decline than men
2023-06-23
ELSE PRESS RELEASES FROM THIS DATE:
Race-neutral testing could have given access to life-saving lung transplants for more black patients
2023-06-23
June 21, 2023 – NEW YORK, NY— Race-neutral lung function interpretation could increase access to lung transplants for Black patients with respiratory disease, according to new research published in the Annals of the American Thoracic Society online ahead of print.
In “Race-Specific Interpretation of Spirometry: Impact on the Lung Allocation Score,” lead researcher J. Henry Brems, MD, MBE of the Johns Hopkins School of Medicine, and colleagues investigated how race-specific versus race-neutral equations alter the lung allocation score (LAS) and the priority for lung transplant across races. The lung allocation score determines ...
Bridging the gap for precision medicine: nanofluidic aptamer nanoarray measures individual proteins
2023-06-23
In the evolving world of precision medicine, the need for methods that can measure biomolecules with supreme accuracy and specificity is paramount. Recognizing this, Associate Professor Yan Xu of the Graduate School of Engineering at Osaka Metropolitan University and his international research team have made a great stride in this direction. They have developed an innovative nanofluidic device capable of capturing single proteins stochastically and detecting them digitally at their naturally high concentrations. This breakthrough could potentially ...
Smart yet simple – creating uniform DNA-encapsulating microgels that mimic a living cell
2023-06-23
The living cell harbors physiologically relevant components such as the genetic material (DNA) and proteins in a ‘self-organized’ setting. Understanding this process of self-assembly can reveal the underlying mechanism of self-organization of living matter. Water/oil (w/o) or water/water (w/w) droplets may be used as prototypes or “models” that mimic cells and can be used to study cellular self-assembly. These models also have major implications in the field of biomedical research. Although cell mimetics can be generated using complicated and high-cost equipment, the associated methods are costly, ...
Even a modest reduction in kidney function increases health risks in young adults
2023-06-23
A study of more than 8 million adults in Ontario, Canada suggests that even a modest loss of kidney function is associated with increased health risks. The study, published in The BMJ, could lead to better approaches to prevent chronic kidney disease and related conditions, particularly in younger adults.
“The dogma is that healthy, young adults don’t need to worry about kidney function unless it drops to around 50% of the normal level, but our research suggests that even a more modest 20-30% drop may have consequences and we may want to have earlier conversations ...
Forensic bitemark analysis for court trials is not supported by sufficient data and “is leading to wrongful convictions”
2023-06-23
The commonly-used evidence in trials, bitemark analysis, is not backed up by scientific research – an analysis of current literature, and 12 new studies, shows.
Published in the peer-reviewed Journal of the California Dental Association, the research suggests 26 people have been wrongfully convicted, and some even sentenced to death, from the use of this forensic science.
“The scientific community does not uphold the underlying premises that human teeth are unique and their unique features transfer to human skin,” states lead author Mary Bush, Associate Professor at the State University of New York in Buffalo, NY.
“We find bitemark transfer ...
COVID-19's impact on socioeconomic inequality in health behaviors among Japanese adolescents
2023-06-23
Key Findings
This study is the first worldwide to investigate time trend in socioeconomic inequality in various health behaviors among adolescents before and during the COVID-19 pandemic.
The study found widening socioeconomic inequality among Japanese adolescents in achieving recommended physical activity levels before and during the pandemic, alongside narrowing inequality in breakfast intake. Specifically, despite no observed differences in physical activity by income in 2019, by 2021, adolescents from families with lower equivalent household incomes were less likely to engage in physical activity.
Research is needed to continue monitoring the impact these phenomena will have ...
More exposure needed for cosmetic breast enhancement risks
2023-06-23
Complications after cosmetic breast augmentation are more common than other cosmetic plastic surgery yet many women who undergo such procedures are often in the dark about the associated risks say QUT researchers.
The authors of a new paper argue the need for more disclosure early (and in much simpler terms) of those risks and the high likelihood of revision surgery being required so when women give their consent, they have a greater understanding of what may happen.
“The Australian cosmetic surgery industry is worth billions but there are concerns inside the industry on potential issues surrounding whether patients ...
Combination therapy effective against canine melanoma
2023-06-23
A combination of radiotherapy followed by immunotherapy is a promising strategy for the treatment of oral malignant melanomas in dogs.
Melanomas are the most common oral cancers in dogs. It is highly metastatic and conventional chemotherapy does not increase survival time. Canine oral melanomas are similar to human melanomas; thus, research is being conducted into adapting treatments developed for human melanomas for dogs.
A particularly effective therapy for treating human melanomas is a combination of immune checkpoint inhibitors and radiotherapy. A team of researchers led by Professor Satoru Konnai at Hokkaido University has investigated ...
Building the semiconductor workforce of the future
2023-06-23
The University of Utah is one of thirteen founding partner members of the Northwest University Semiconductor Network, a partnership with and created by Micron Technology, Inc. whose goal is to help develop the next generation of the United States’ semiconductor industry’s workforce.
Micron, one of the world’s largest semiconductor companies, made the announcement on Monday. In a press release the company stated the Northwest University Semiconductor Network will “drive foundational and emerging research to increase students’ ...
New rapid viral plaque detection system, aided by deep learning and holographic imaging, can help accelerate vaccine and drug development
2023-06-23
Findings
In a new paper published in Nature Biomedical Engineering, a team of scientists led by Professor Aydogan Ozcan from the Electrical and Computer Engineering Department at UCLA and an associate director of the California NanoSystems Institute, developed a rapid, stain-free, and automated viral plaque detection system enabled by holography and deep learning. This system incorporates a cost-effective and high-throughput holographic imaging device that continuously monitors the unstained virus-infected cells during their incubation process. At each imaging cycle, these ...