Women with atrial fibrillation progress more rapidly to cognitive impairment and dementia than men with heart rhythm conditions, according to research. Atrial fibrillation is the most common heart rhythm disorder, affecting more than 40 million people worldwide.

Women have more atrial fibrillation symptoms than men and worse outcomes from the disorder, with a higher risk of death and more disabling strokes, said researchers presenting the study at the ongoing ACNAP 2023, a scientific congress of the European Society of Cardiology (ESC).

“Symptoms of atrial fibrillation in women are often ignored by healthcare providers or attributed to stress or anxiety so it can go undiagnosed for a long period of time, while men are more likely to be diagnosed and treated quickly,” said study author Dr Kathryn Wood of Emory University, Atlanta, US.

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“Being undiagnosed means not receiving oral anticoagulant medication to prevent blood clots and strokes caused by atrial fibrillation. These women may be having clots that go to small blood vessels in their brain, causing them to lose brain function gradually and develop cognitive impairment,” she added.

Dementia is more common in women than men. Atrial fibrillation is associated with a higher risk for cognitive impairment and dementia, possibly because the condition is linked with a more than two-fold risk of silent strokes. Stroke prevention with oral anticoagulant drugs is the main priority in the management of atrial fibrillation and may reduce the risk of dementia.

“However, we know that women are less likely to receive these medications than men. This is another reason why women may have small silent strokes that go unrecognised and damage brain tissue leading to cognitive impairment,” Dr. Wood said.

In the study, published in the journal Alzheimer’s & Dementia, the team included 43,630 participants from the US. Women with atrial fibrillation were three times more likely to have mild and rapid cognitive impairment and dementia compared to women without heart rhythm disorder. In men, the association was found statistically insignificant.


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