Resident Physician The Ottawa Hospital Ottawa, Ontario, Canada
Background: Cardiac arrhythmias are common in older adults. Emerging evidence suggests that even in the absence of major complications such as stroke, cardiac arrhythmias may play an important role in the development and progression of cognitive impairment.
METHODS AND RESULTS:
Methods: We performed a systematic review and network meta-analysis exploring the impact of cardiac arrhythmias on cognitive function in older adults. We searched MEDLINE, EMBASE (Ovid), APA PsycInfo (Ovid), Web of Science (Core Collection) and Ageline (Ebsco) from inception through to June 3rd, 2024. Two reviewers performed screening, full-text review, and extraction independently. We excluded studies with a mean/median age younger than 60 as well as confounding concurrent disorders such as severe or untreated psychiatric illness, substance use disorders, cirrhosis with hepatic encephalopathy, HIV, multiple sclerosis, Parkinson’s, or Huntington’s disease.
Results: Eleven studies with 35,698 patients evaluated the prevalence of dementia in older adults with cardiac arrhythmia. Three studies with 43,478 patients evaluated cognition over time. Compared to patients in sinus rhythm, the prevalence of dementia was higher in older adults with cardiac arrhythmia (OR 1.78, (1.18, 2.69), p = 0.006). In longitudinal cohorts, patients with atrial fibrillation experienced greater reductions in cognitive scores over time (-0.17 [-0.25,-0.10], p< 0.000001).
Conclusion: Compared to patients in sinus rhythm, older adults with cardiac arrhythmia have a higher prevalence of dementia and experience greater rates of cognitive decline.
