Department of Neuroscience, Laboratory of Quality Assessment of Geriatric Therapies and Services, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy; University of Birmingham Institute of Cardiovascular Sciences, Birmingham, United Kingdom.
Department of Neuroscience, Laboratory of Geriatric Neuropsychiatry, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy.
Eur J Intern Med. 2017 Dec;46:6-10. doi: 10.1016/j.ejim.2017.08.010. Epub 2017 Aug 9.
Atrial fibrillation (AF) and dementia are largely prevalent and incident in progressively older subjects, suggesting a link between the two conditions. While in the general population there are several findings supporting a causal relationship between AF and dementia, it is unclear whether or not this association is still present in individuals aged 80 and older.
So far, the few studies that analysed this issue did not provide enough evidence supporting the causative role of AF in increasing the risk of cognitive decline or dementia in patients aged 80 and older. Conversely, a relevant role of optimal anticoagulation control in determining a significant reduction in the risk of cognitive decline is suggested, in AF subjects aged 80years or older.
Further data, coming from population-based studies specifically investigating very old individuals and based upon large samples and comprehensive cognitive assessments, are needed to fully elucidate the relationship between AF and dementia in very old individuals.
心房颤动(AF)和痴呆在逐渐老龄化的人群中普遍存在且发病率不断上升,这表明两者之间存在关联。虽然在一般人群中,有多项研究结果支持 AF 和痴呆之间存在因果关系,但在 80 岁及以上的人群中,这种关联是否仍然存在尚不清楚。
到目前为止,少数分析这一问题的研究并未提供足够的证据支持 AF 在增加 80 岁及以上患者认知能力下降或痴呆风险方面的因果作用。相反,在 80 岁及以上的 AF 患者中,抗凝控制达到最佳状态与认知能力下降风险显著降低之间存在着重要的关联。
需要进一步的来自于基于人群的研究的数据,这些研究特别针对非常高龄的个体,基于大样本和全面的认知评估,以充分阐明在非常高龄个体中 AF 和痴呆之间的关系。