The Link Between Atrial Fibrillation And Cognitive Impairment: A Systematic Review And Meta-Analysis

Atrial fibrillation (AF) affects a substantial population of individuals aged ≥55 years globally and has been associated with an increased risk of cognitive impairment (CImp) due to the shared risk factors such as aging, obesity, and diabetes. It is essential to comprehend their unique relationship to manage them effectively to reduce its impact on public health systems. We performed a PubMed search of English language papers published till 31 May 2023. Data was extracted and effect measures were calculated. Meta-analysis of 33 studies revealed a significant association between AF and CImp after adjusting for comorbidities, with considerable between-study heterogeneity (pooled OR: 1.62; 95% CI: 1.43, 1.81, I 2 = 94.143). Prospective and cross-sectional studies revealed substantial associations. CImp in AF may be mediated through silent brain infarctions, microemboli, brain atrophy, and inflammation. Future research should prioritize investigating the mechanisms and etiology of this association, as well as potential treatment options.