Impact of Atrial Fibrillation on Cognitive Function, Psychological Distress, Quality of Life, and Impulsiveness.

OBJECTIVE: Atrial fibrillation is the most common cardiac arrhythmia and a known risk factor for cerebrovascular stroke. Atrial fibrillation and longstanding hypertension may produce ischemic lesions leading to progressive cognitive impairment. The impact of atrial fibrillation alone on cognitive impairment has not been evaluated. Our objective was to compare cognitive function, quality of life, psychological distress, and impulsiveness in people with atrial fibrillation and a matched control group.

METHODS: The study included 60 patients. The first group of patients were ≥55 years of age, with ≥5 years history of atrial fibrillation, without hypertension (or with well-controlled hypertension), without previous dementia, compared with a matched group of 30 healthy control participants. Demographic and clinical characteristics were recorded. Subjects underwent the following rating scales: Mini-Mental State Examination, Hospital Anxiety and Depression, Heart Quality of Life, and Barratt Impulsiveness Scale.

RESULTS: In the atrial fibrillation group there were 63% male (n = 19) and 37% female (n = 11) patients; the control group was 33% male (n = 10) and 67% female (n = 20). Age range was from 55 to 81 years in both groups, mean = 63.9 years (±6.4) in the atrial fibrillation group and 66.1 years (±8.0) in controls. In the atrial fibrillation group, 23.3% had primary or general education, college - 23.3% and university - 53.3%; in the control group - 20%, 23.3%, and 56.7%, respectively. Mini-Mental State Examination score was 27.6 (±1.6) in the atrial fibrillation group vs 29.5 (±0.73) in the control group (P < .0001). Anxiety disorders were observed in 20 patients (66.7%) in atrial fibrillation vs 8 patients (26.67%) in the control group (P = .009). Heart Quality of Life mean score was 1.4 (±0.65) in the atrial fibrillation and 2.6 (±0.35) in the control group (P < .0001). Physical subscale mean scores were 1.4 (±0.74) in atrial fibrillation vs 2.8 (±0.18) in the control group (P < .0001).

CONCLUSION: Individuals with atrial fibrillation are more likely to develop anxiety disorder. Cognitive status is significantly lower in the atrial fibrillation group. In comparison with healthy subjects, individuals with atrial fibrillation have worse quality of life.