A couple of weeks ago, one of my best friends called to tell me she was having atrial fibrillation. Her doctor put her on an anticoagulant. She was asking for my opinion and of course I told her to follow her doctor’s orders and take the medication. After reading this study, I question if I told her the correct answer. I wonder if there was any disclosures about the side effects of anticoagulant and dementia.
Medical data was collected from 6,000 patients where the study showed that individuals with atrial fibrillation (AF), who take anticoagulants, are at a higher risk of dementia than those patients who take the blood-thinning drugs for other reasons. AF is the most common irregular heartbeat condition where the incidence rate of the adult population aged 65 and older is 10%. This is reported by the Atrial Fibrillation Association (AFA). Most of the time AF is not life-threatening, but it is known to be a leading cause of stroke.
The Intermountain Medical Center Heart Institute researchers in Salt Lake City, UT compared medical notes of the patients who regularly took anticoagulants and found that dementia cases were higher among the AF patients. The findings of the team were presented at the American Heart Association Scientific Sessions 2016 that was held in New Orleans, LA.
The anticoagulant therapy is used to thin the blood of AF patients and the most commonly used is warfarin. These AF patients are prone to developing blood clots because their irregular heartbeat prevents the blood from being pumped through the chambers of the heart efficiently and can lead to pooling of the blood and subsequent formation of blood clots.
These blood clots can then travel to the brain and cause a stroke. Three million people worldwide are affected by AF-related strokes each year, according to the AFA.
A number of diseases that affect the brain and cause progressive intellectual decline are dementia. The most common form of dementia is Alzheimer’s disease, even though there are many others. The National Institutes of Health state that there are approximately 5 million individuals in the U.S. who have Alzheimer’s disease. The leading cause of death in England and Wales is dementia. The statistics are reported by the United Kingdom Office for National Statistics. The main risk factor for dementia is thought to be age, and the number of those living with dementia is expected to increase, as life expectancy is becoming longer.
A study of medical notes has brought the team to conclude that patients with AF who took warfarin were two to three times more likely to have dementia than those without AF, who took warfarin. In conclusion, the authors believe that taking warfarin is associated with an increased risk of dementia in all patients, but more so in AF patients.
Dr. Jared Bunch, Lead author and director of electrophysiology at the International Medical Center Heart Institute says, “Atrial fibrillation patients are at higher risk of developing all forms of dementia compared to patients without atrial fibrillation”. Even though warfarin is used to lower risk for stroke in patients with AF it contributes to the dementia risk when the blood levels of the drug are erratic. This risk is observed in people with and without AF that are exposed to long-term warfarin treatment.
–Dr Fredda Branyon