A Common Heart Problem May Lead to Dementia: Studies


Several studies have linked a common heart arrhythmia to dementia. Atrial fibrillation (AFib) is the most common type of heart arrhythmia and affects at least 3 to 6 million people in the United States alone and over 37 million worldwide. It becomes increasingly common with advanced age and affects up to 9 percent of the population by age 80. While AFib is already proven to increase the risk of stroke, recent studies show it may also play a part in the development of dementia and Alzheimer’s disease.

What Is Atrial Fibrillation?

Atrial fibrillation is an abnormal heartbeat caused by an electrical malfunction inside the heart. When your heart beats regularly, it contracts and relaxes in a steady rhythm. But when your heart is in AFib, the upper chambers beat quickly, essentially “quivering,” making it feel like your heart skips a beat, is racing, or is fluttering. Many people describe it as feeling like there is a butterfly inside of their chest.

Atrial fibrillation can be constant, or your heart can intermittently go from AFib and back to a regular rhythm.

Strangely, some people never feel their hearts beating abnormally. Other times, symptoms can get uncomfortable and cause shortness of breath, dizziness, or weakness.

The risk of stroke with AFib is high because when your heart isn’t beating properly and the upper chamber is only quivering, blood tends to pool and create blood clots that travel from your heart where they lodge inside smaller arteries in your brain, blocking blood flow and potentially resulting in a stroke.

But a series of studies performed by Dr. Jared Bunch, a cardiologist from The University of Utah, and his colleagues, have shown that patients with AFib had higher rates of multiple types of dementia, including Alzheimer’s, than patients without AFib. [1][2]

Other studies have found the troubling reality that although AFib and dementia are typically diseases of the elderly, there’s an elevated increase in relatively young AFib patients (less than 67 to 70 years of age).

How Atrial Fibrillation Increases Dementia Risk

A healthy brain requires regular blood flow, which is its source of oxygen. During episodes of AFib, the heart is beating quickly and at variable rates, making it difficult for blood to pump to the brain effectively. The resulting decreased blood flow to the brain eventually reduces its volume, causing atrophy and cognitive decline.

Researchers also believe that the small blood clots formed inside the heart during AFib can travel deep inside the brain and cause “ministrokes.” These “ministrokes” don’t come with typical stroke symptoms and can go undetected. Unfortunately, without sufficient blood flow and oxygen, the brain cells in these areas die, resulting in cognitive decline.

Bunch and his team also recognize that patients with Alzheimer’s disease and those with AFib often show signs of inflammation, oxidative stress, and vascular dysfunction—symptoms that may relate to hypertension, obesity, physical inactivity, and metabolic syndrome.

Epoch Times Photo
The mechanism behind dementia and the cognitive decline related to AFib. (The Epoch Times)

Dr. Atif Zafar, a board-certified neurologist and chief of the stroke program at St. Michael’s Hospital at the University of Toronto, told The Epoch Times that another potential link between AFib and dementia could be at the molecular level. He notes studies that show specific molecules called NT-proBNP can be elevated in patients with AFib. [1][2][3]

“This molecule is likely prothrombotic, and while many of us are curious to see how these molecules impact stroke, we are also concerned about the long-term cognitive decline in patients with AFib,” said Zafar.

For those who may or may not know if they have AFib and want to reduce the risk of dementia and cognitive decline, Zafar says to be aware of symptoms and assess your risk factors.

Symptoms of AFib

Some symptoms of AFib to watch out for are heart palpitations, fluttering in your chest, or feeling like your heart skips a beat. Many people don’t realize their heart is beating irregularly; their only symptom is fatigue and lack of normal energy. Additional symptoms may include:

  • Shortness of breath
  • Sweating
  • Anxiety
  • Weakness
  • Dizziness
  • Confusion
  • Chest pain and pressure

The most common risk factors for AFib are advancing age and high blood pressure. Additional risk factors may include diabetes, obesity, alcohol use, and smoking.

When you have symptoms, especially with associated risk factors, it is imperative to get a diagnosis to treat the AFib and deter further complications.

Zafar strongly advocates utilizing smartwatches and other devices to monitor your heart rhythm.

“Do I see an instrumental role of smartwatches and digital screening devices? Absolutely!” said Zafar. He and other colleagues see patients who have been alerted to AFib by their smartwatches. Zafar believes these types of “health gadgets” will help improve heart and brain health by triggering physicians to screen for AFib. These screenings aren’t routinely recommended for everyone over 50, yet can help identify more people who aren’t necessarily symptomatic but do have an abnormal heart rhythm.

Treating AFib to Decrease Risk of Dementia

There are various treatments for AFib, including lifestyle changes, medications, and other procedures. Healthy lifestyle changes, according to Zafar, include losing weight if you are obese, reducing your blood pressure, exercising at least 20 to 30 minutes daily, and managing sleep apnea. These will minimize your risk of AFib and positively impact your brain health.

However, even if you follow these lifestyle recommendations, your cardiologist or primary care physician may recommend a blood thinner or medications that regulate your heart rhythm, based on your overall health and to reduce your risk for cognitive decline and dementia.

Another possible intervention is a procedure called a catheter ablation, which may be recommended when your AFib persists, despite lifestyle changes and medications. An ablation is described by the American Heart Association as a generally safe procedure where an electrophysiologist places a catheter at the exact site in your heart where abnormal electrical signals are causing the AFib. Radiofrequency energy is then used to destroy the small area causing the electrical problems. The catheter ablation can resolve your AFib symptoms, but it’s not a guarantee. Some people find the AFib persists and may be advised to stay on blood thinners and heart rhythm medications to control symptoms and to help the heart pump adequately.

Allison DeMajistre, BSN, RN, CCRN is a freelance medical writer for The Epoch Times. She is a registered nurse who previously worked in critical care. She specializes in cardiology-related topics.
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