Abstract
BACKGROUND
Atrial fibrillation (AF) is a common cardiac arrhythmia associated with significant cardiovascular morbidity and mortality, as well as cognitive impairment (CI). The interplay between AF and CI is complex, involving various pathophysiological changes and numerous risk factors. Among them, depression has emerged as a significant contributor to both AF and CI, further complicating the relationship between these conditions.
OBJECTIVES
This systematic review and meta-analysis aimed to investigate the influence of depression on the development of cognitive impairment in AF patients and assess the predictive value of the CHA2DS2-VASc score for CI risk.
METHOS
We searched PubMed, Scopus, and Web of Science for relevant studies without language or date restrictions. Ten studies, comprising 1,605,577 participants, were included. A random-effects model was used for meta-analysis, and heterogeneity was assessed using I2 statistics. Funnel plots and Egger's test evaluated publication bias.
RESULTS
Depression significantly increased the risk of CI in AF patients (OR: 2.23, 95% CI: 1.54-3.21, p<0.01; I2=99%). This association persisted in studies excluding baseline CI (OR: 1.95, 95% CI: 1.33-2.85, p<0.01; I2=88%). Subgroup analysis confirmed these results for both prospective (OR: 1.78, 95% CI: 0.92-3.44, p=0.02; I2=65%) and retrospective studies (OR: 2.63, 95% CI: 1.75-3.93, p<0.01; I2=100%). Analysis of CHA2DS2-VASc risk factors showed associations with CI, particularly cerebrovascular disease (OR: 1.86, 95% CI: 1.61-2.16).
CONCLUSIONS
Our findings support the association between depression and cognitive impairment in AF patients, demonstrating the importance of addressing mental health in cardiovascular care. Future research is necessary for a comprehensive understanding of this association.
Atrial fibrillation (AF) is a common cardiac arrhythmia associated with significant cardiovascular morbidity and mortality, as well as cognitive impairment (CI). The interplay between AF and CI is complex, involving various pathophysiological changes and numerous risk factors. Among them, depression has emerged as a significant contributor to both AF and CI, further complicating the relationship between these conditions.
OBJECTIVES
This systematic review and meta-analysis aimed to investigate the influence of depression on the development of cognitive impairment in AF patients and assess the predictive value of the CHA2DS2-VASc score for CI risk.
METHOS
We searched PubMed, Scopus, and Web of Science for relevant studies without language or date restrictions. Ten studies, comprising 1,605,577 participants, were included. A random-effects model was used for meta-analysis, and heterogeneity was assessed using I2 statistics. Funnel plots and Egger's test evaluated publication bias.
RESULTS
Depression significantly increased the risk of CI in AF patients (OR: 2.23, 95% CI: 1.54-3.21, p<0.01; I2=99%). This association persisted in studies excluding baseline CI (OR: 1.95, 95% CI: 1.33-2.85, p<0.01; I2=88%). Subgroup analysis confirmed these results for both prospective (OR: 1.78, 95% CI: 0.92-3.44, p=0.02; I2=65%) and retrospective studies (OR: 2.63, 95% CI: 1.75-3.93, p<0.01; I2=100%). Analysis of CHA2DS2-VASc risk factors showed associations with CI, particularly cerebrovascular disease (OR: 1.86, 95% CI: 1.61-2.16).
CONCLUSIONS
Our findings support the association between depression and cognitive impairment in AF patients, demonstrating the importance of addressing mental health in cardiovascular care. Future research is necessary for a comprehensive understanding of this association.
| Original language | English (US) |
|---|---|
| Article number | 105601 |
| Journal | Archives of Gerontology and Geriatrics |
| DOIs | |
| State | E-pub ahead of print - Aug 14 2024 |
Keywords
- Atrial fibrillationrisk factorsdementiacognitive impairmentcognitive decline