P2893Cognitive decline is more common in persistent atrial fibrillation than in paroxysmal atrial fibrillation in geriatric patients

Le résumé fourni par la source

Introduction: Atrial fibrillation (AF) is a known risk factor for cognitive decline and development of a dementia. We have recently demonstrated that cognitive decline in old patients with cardiovascular conditions is better detected using the Montreal Cognitive Assessment (MoCA) than the Mini Mental State Examination (MMSE). Elderly patients who are referred to an ambulatory geriatric fall and syncope day clinic are very often known with AF and cognitive disorders. Purpose: To evaluate cognitive functioning of geriatric patients with AF, using the MoCA and MMSE. Methods: Observational cohort study at the fall and syncope day clinic, including patients aged 65 years or older between 2011 and June 2017. The patients that were tested with both the MoCA and MMSE were included in the analysis. Results: We included 428 patients with a mean age of 80±6.5 years. Of these, 280 patients (65.4%) were female. 101 patients had AF of which 55 cases (54.5%) were paroxysmal. Their mean number of co-morbidities, CHA2DS2VASc and HAS-BLED score were 10.7±5.3, 4.0±1.5 and 2.9±1.1, respectively, and are not significantly different between those with sinus rhythm, paroxysmal or persistent AF. On the MMSE the mean score of all 428 patients was 27.2±2.4 points. Using a MMSE score <26 points as cut-off 78 patients (18%) showed cognitive decline of which the mean score was 23.2±1.9 points. With the MoCA, the mean score was 23.7±3.8 points. Using a MoCA score <26 points as cut-off 278 patients (65%) showed cognitive decline, with a mean score of 21.7±3.1 points. Patients with persistent AF showed a tendency towards a lower score on the MoCA than those with sinus rhythm (22.6 vs. 23.7 points, p=0.065). Significantly more cognitive decline was found using the MoCA in patients with persistent AF, namely in 37 patients (80.4%), compared to 32 (58.2%) patients with paroxysmal AF, p=0.017 and in 209 (63.9%) patients with sinus rhythm, p=0.027.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.