Study Shows Relationship Between Atrial Fibrillation And Development Of Alzheimer's Disease
Main Category: Cardiovascular / CardiologyAlso Included In: Alzheimer's / Dementia
Article Date: 16 May 2009 - 0:00 PDT
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Researchers at Intermountain Medical Center in Salt Lake City believe that they have made a breakthrough connection between atrial fibrillation, a fairly common heart rhythm disorder, and Alzheimer's disease, the leading form of dementia among Americans.
In a study presented May 15, at "Heart Rhythm 2009," the annual scientific sessions of the Heart Rhythm Society in Boston, researchers unveiled findings from the study of more than 37,000 patients that showed a strong relationship between atrial fibrillation and the development of Alzheimer's disease.
The study, which drew upon information from the Intermountain Heart Collaborative Study, a vast database from hundreds of thousands of patients treated at Intermountain Healthcare hospitals, found:
- Patients with atrial fibrillation were 44 percent more likely to develop dementia than patients without the heart disorder.
- Younger patients with atrial fibrillation were at higher risk of developing all types of dementia, particularly Alzheimer's. Atrial fibrillation patients under age 70 were 130 percent more likely to develop Alzheimer's.
- Patients who have both atrial fibrillation and dementia were 61 percent more likely to die during the study period than dementia patients without the rhythm problem.
- Younger atrial fibrillation patients with dementia may be at higher risk of death than older AF patients with dementia.
"Previous studies have shown that patients with atrial fibrillation are at higher risk for some types of dementia, including vascular dementia. But to our knowledge, this is the first large-population study to clearly show that having atrial fibrillation puts patients at greater risk for developing Alzheimer's disease," said Dr. Bunch.
Alzheimer's is a devastating brain disease affecting approximately 5.3 million Americans. It is the most common form of dementia (a general term for life-altering loss of memory and other cognitive abilities), and accounts for 60-80 percent of all dementia cases. Today, it is the sixth leading cause of death in the United States.
Currently, the known risk factors for Alzheimer's are age, family history and genetics, though injury may also be linked with the disease. Heart health has long been suspected to play a role, but has not been linked. The Intermountain Medical Center study bolsters that connection.
"The study shows a connection between atrial fibrillation and all types of dementia," said Bunch. "The Alzheimer's findings - particularly the risk of death for younger patients - break new ground."
Atrial fibrillation is the most common heart rhythm problem, affecting about 2.2 million Americans. It occurs when the heart beats chaotically, leading blood to pool and possibly clot. If the clot leaves the heart, a stroke can result.
The Intermountain Medical Center study looked at five years of data for 37,025 patients. Of that group, 10,161 developed AF and 1,535 developed dementia during the study period.
The study authors say more research is needed to explore further the relationship between atrial fibrillation and the development of Alzheimer's disease.
"Now that we've established this link, our focus will be to see if early treatment of atrial fibrillation can prevent dementia or the development of Alzheimer's disease," says cardiologist John Day, M.D., director of heart rhythm services at Intermountain Medical Center and a co-author of the study.
Source:
Jess Gomez
Intermountain Medical Center
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Visitor Opinions In Chronological Order (2)
Atrial fibrillation and Alzheimer’s disease
posted by Rovshan Ismailov MD MPH PhD on 27 Oct 2010 at 4:54 pmThe idea that ineffective left ventricular function and hemodynamic “instability” play an important role in the development of Alzheimer’s disease and vascular dementia has not been substantially developed. For instance, only a few population studies suggest that there is an association between atrial fibrillation and Alzheimer’s disease progression[1]. However, no serious consideration of the mechanism has been provided.
One of the mechanisms that can describe an association between cardiac pathology (i.e. cardiac arrhythmia) and Alzheimer’s disease is the disturbances in the dynamics of regional brain extravascular extracellular fluid[2]. Such consideration of regional brain extravascular extracellular fluid dynamics is also particularly important in light of the fact that certain waste products such as glutamate or calcium can accumulate there causing degradation of certain cellular components thus playing an important role in the pathogenesis of Alzheimer’s disease[3,4].
Such mechanism proposes that the regional brain extravascular extracellular fluid gets moved due to the cyclic changes in the vessel wall deformation, a sort of a “deformation pump”[2]. The operating principle of the “deformation pump” is in the cyclic creation of the boundary layer and in its separation. Thus the movement of the regional brain extravascular extracellular fluid happens as a result of the appearance and separation of the boundary layer at the close proximity to the vascular wall. The obvious implication of this mechanism is the primary involvement of cardiovascular system in the development of Alzheimer’s disease.
Correspondinlgy to theoretical results, the important populaiton-based finding was that the proportion of patients diagnosed with both sick sinus syndrome and Alzheimer’s disease was significantly higher (P < 0.001) compared to the proportion of those patients diagnosed with Alzheimer’s disease and any other discharge diagnoses, followed by the remaining proportions (i.e. atrial fibrillation and Alzheimer’s disease; sinus bradycardia and Alzheimer’s disease)[2].
Rovshan M Ismailov, M.D., M.P.H., Ph.D.
References
[1] Mielke MM, Rosenberg PB, Tschanz J et al. Vascular factors predict rate of progression in Alzheimer disease. Neurology 2007; 69(19):1850-8.
[2] Ismailov RM. New insights into the mechanism of Alzheimer's disease: A multidisciplinary approach . edn. Amazon Kindle, 2010.
[3] Mattson MP. Calcium as sculptor and destroyer of neural circuitry. Exp Gerontol 1992; 27(1):29-49.
[4] Khachaturian ZS. The role of calcium regulation in brain aging: reexamination of a hypothesis. Aging (Milano) 1989; 1(1):17-34.
A-Fib and Raynauds
posted by Rob Goodman on 2 Mar 2011 at 10:34 amI went to ER for shortness of breath and inability to sleep. Diagnosed as congestive heart failure. Tests diagnosed me also as A-Fib. I am 81. Later, from comment in my coumadin clinic, I was diagnosed with Raynauds' Syndrome. My feet, toes, hands and fingers are always cold and the condition seems to be progressing. My fingers seem to shrink when I bowl and the ball tends to slip out of my hand. My feet feel like I'm walking with my socks bunched up on the balls of my feet. I've seen my Fam Dr. and Cardiologist but they don't seem concerned. Your opinion, please.
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