This is as always a thought provoking post from Dr Gupta
AFIB and Dementia: This is as always a... - Atrial Fibrillati...
AFIB and Dementia
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dmac4646
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I just watched this on another site....This has really worried me....As if we didn't already have enough to be concerned about....feeling sad... 
Its not great news but underlines the need to pay attention to lifestyle factors..
After listening to this talk I'm glad that I had my three ablations, even if they didn't totally cure my AF they have certainly helped reduce my symptoms and it seems my chances of getting conditions like Dementia are reduced because of having had them.
Jean
Having lost my grandmother to senile dementia and my mother to vascular dementia. Ouch 😢
I know the feeling... Horrible seeing loved ones suffer through demetia...
Wow I am so glad to have had this video flagged up to me. Thank you so much. This is such important information and knowledge is always power, even if, as yet, there is little that is actually proven to link AF to dementia!
Am I alone in feeling that this video is inappropriate? The only NEW practice point is the suggestion of modifying CHADS2vasc.Against that is the likelihood that patients will be even more anxious.
Dr Gupta is a clever, articulate and persuasive man. His opening remarks appeared to me to betray an anti medical establishment bias. I’m with him on that.
KMRobbo in reply to
I do not think it was inappropriate. He us suggesting we look out for ourselves where possible. Which is what a lot of us try to do anyway. As to anti establishment? The main point is that money talks, no likely money stream , no/little research. That unfortunately is not new .
in reply to KMRobbo
That was my point exactly. There is nothing new here for most of us. It follows that we can now apparently add dementia to the list of things to fret about, while not being able to do a damn thing about it. You won’t find a GP or most cardiologists starting anticoagulants in a 40 year old with a CHADDs score of 0 after a first episode of AF. I wonder if Dr Gupta does.Not mentioned but probably important would be high dose statin use (for anti-inflammatory effect), if any evidence of atherosclerosis. Cholesterol levels are irrelevant according to expert opinion.
LaceyLady in reply to
What you know about you can address to improve your chances of not getting it.
Better keep on drinking the tea & coffee then…..
Coffee or Tea? Drinking Both Tied to Lower Stroke, Dementia Risk
His YouTube channel is very informative and he likes to keep us informed of developments as and when they happen. I guess a lot of this information would be hidden if not for people like him, but I guess it's down to the individual on whether they find this helpful or not. This latest video on possible dementia links with AF is worrying but forewarned is forearmed as far as I'm concerned. I have a telephone appointment in February with my cardiologist, and I find it easier to have a conversation if I'm familiar with the topic, whatever the circumstances.
The link between Dementia and AF has been known for some time - there are some evidence based studies which show that taking anticoagulants along with Lifestyle factors can mitigate the risk. Even so - you can’t stop the clock ticking and age and maintaining BP low is going to always be a big factors.
Had an awful day, all I needed to cheer me up 🙄 One of my GPs told me I shouldn’t go too long in fast AF because I’d lose little grey cells from oxygen starvation 😨 Nothing can be done about my AF unless I have a pacemaker but that’s not considered urgent, so guess I’ll just have to stick with the ‘healthy(ish) lifestyle’ 😐
AF does increase the risk of dementia, but anticoagulants reduce that risk. See this study: medscape.com/viewarticle/90...
AF was found to increase the risk of dementia by 40% but anticoagulants reduced risk by 60%. It is particularly important with warfarin to get good INR results. In this study,
pubmed.ncbi.nlm.nih.gov/293...
for those with a time in therapeutic range greater than 70%, the risk of dementia is only a third compared with poor control (see the table at the bottom).
So for well controlled warfarin at least, there is no increased risk of dementia.
Hi Mark thank you for this ,very reassuring. Is the same response / protection for NOACs? I'm on Apixaban.Cheers
Soon after I was diagnosed with PAF I researched the condition and soon discovered the cognitive/dementia risk mentioned in the video. I don't know if it applies mostly to persistent/permanent AF or to PAF as whenever I have raised this topic with cardiologists they often don't answer or try to change the subject, presumably because they don't want to cause alarm. Some cardiac nurses I spoke to professed not to know anything about it. One issue is that of anticoagulation. In the video Dr Gupta comes down in favour of it, but at one point mentions that it could make the situation worse. So it's not entirely clear what the situation is. Also, if an anticoagulant is better than none, is warfarin a better option than DOACS? In the meanwhile, I guess all any of us can do is attend to diet, exercise, interact with others and study challenging subjects like mathematics all of which are supposed to be good for cognitive development and the brain.
dmac4646 in reply to
He said anticoagulation as soon as possible after onset of AF may be protective but that more studies needed but unlikely due to costs and time.
CDreamer in reply to
My understanding is that both vascular dementia - caused by tiny bleeds within the brain - can cause - and stroke and dementia caused by clots mean dammed if you do and if you don’t take anticoagulants so it is up to individual risk:benefit assessment. I know in the past some nursing homes wouldn’t take infirm people on anticoagulants as they felt the risk of falling and causing a bleed was high. Hopefully that blanket view has now been modified.
in reply to CDreamer
This healthline article suggests that attending to various bio markers may be of some preventive value: healthline.com/health-news/...
in reply to
As MarkS has said above, Warfarin is superior to DOACS if regular INR measurements are in the therapeutic range in excess of 80% of the time.I don’t have a clue what the therapeutic range is for my Apixaban.
Warfarin scored poorly against DOACS in the original studies because control was poor.
No profit in warfarin. Loadsamoney in DOACS.
this gets more and more depressing. After caring for my husband who had dementia (he had no other health issues) I would not wish this nightmare to happen to me and my adult children having to deal with it again
Have just watched the video. My neighbour insists on passing her Express paper to us so I was flipping through last Sunday's Express and there was an article about heart disease and dementia. I can't remember now if it was AF particularly or HF - I have both. Unfortunately, I put the paper in the recycling and it has gone. There seemed to be a suggestion that the issue was lack of oxygen to the brain because the heart is not working efficiently and I think it said that BHF have now received funding to do more research in this are. However, as Dr Gupta says, any findings may well come too later for some of us as it may take years to trickle down into guidelines and, in any case, the process leading to dementia has started long before it is diagnosed.
I have PAF & live in North Carolina. Have been taking Eliquis several years now and it is extremely expensive. I had hoped to be able to get my condition under control and go off the Eliquis. But these findings make me realize that this is something I may need to continue for the rest of my life. I am feeling a little hopeless.
Should all of us on anticoagulants then offer to pay for a brain scan to check for any ? microfarcs? or is it best not to start a process that could make us worry even more.
I was thinking the same thing.
I’m feeling a bit depressed after watching Dr Gupta’s video! I hope anti coagulation meds will protect us from the risk of dementia - or reduce the risk. Thank you for raising this dmac4646
It’s not the best , but better to know and consider what can be done - it seems to me that anticoagulation is very important indeed and quite a few people with AFIB do not get that - aspirin is not an anticoagulant
I came across this video somewhere else and it didn’t surprise me overly, but I’ve now got T2 diabetes probably through a ‘virus’ , I’ve had 2 unexplained‘viruses’! Seeing this was ‘Oh joy, NOT’, but we have to do as much as we can to slow or stop it’s progression.
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