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AF and Cognitive Impairment

Czech_Mate profile image
38 Replies

I'd like to raise this topic for general discussion as it seems to be one side of Afib that rarely gets mentioned.What are people's experiences and recommendations?

A few years ago I used to teach English in a company where they encouraged staff to have "Aha" moments (the insants when you come up with a wonderful idea). These days I have more "Er her" moments when either I can't remember something or I realise I've done something less than sensible.

I try various things in an attempt to help, but I'm not sure if they help. I attend a University of 3rd Age course (on forestry) but sometimes find I'm completely lost. OK it's in Czech, which is not my first language, but I've been here for 30+ years. While on the subject of using more than one language, we read that it's suppose to help the old grey matter, but in a conversation I find myself forgetting a word that I knew (even in English - my first language). I go to yoga classes 2x a week, which I think helps; the asanas that require balance are particularly challenging but useful. Then I have a piano keyboard I bought during lockdown and although I have little musical talent I'm making progress (2 steps forward, 1.999999 steps back) with a couple of tunes (in 4 years), having to do something different with various fingers on right and left hands is so confusing.

Sorry for rattling on. Any comments and other experiences?

Cheers CM

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38 Replies
BobD profile image
BobDVolunteer

There has been some suggestion occasionaly that AF increases the risk of dementia but I was alway of the opinion that provided we took our anticoagaulants on a regular basis then we were protected to a greater extent than not.

I know that the practise of continuing anticoagulants during ablation was to combat micro embolii which it was thought could be the cause of brain fog due to extremely small clots getting into the brain. Having just had my 79th birthday I know your fear and of course we do all get a lttle vague as we get older.

jeanjeannie50 profile image
jeanjeannie50

My memory has become dreadful. If on my own, the word I want (but cant think of) comes about 3 to 5 minutes later but of course if you're mid sentence talking to someone that's of no use. My best friend who isn't on any medication is exactly the same, perhaps not quite as bad as me. At times she can even tell me who the producer of a film was. Me, I couldn't tell you one producer but that has never been something of interest for me.

Jean

Czech_Mate profile image
Czech_Mate in reply tojeanjeannie50

Yes, the anticoagulants we take are said to help, but I feel that the beta blockers can affect our cognitive performance. Recenty I've had to change from Metoprolol Succinate to Metoprolol Tartarate due to unavailability here and I'm sure that's made a difference.

jeanjeannie50 profile image
jeanjeannie50 in reply toCzech_Mate

I take Metoprolol Tartrate too.

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply toCzech_Mate

Hi

Metoprolol is on my banned list. Breathless, fatigued on any exertion. H/Rate 185 uncontrolled AF rapid and persistence.

A 24-hr heart monitor showed pauses at night.

I was changed to Bisoprolol and steadily raised in dosage. 154 h/rate.

I went to a Private Heart Specialist who introduced a CCB Calcium Channel Blocker.

Now with 60s avge H/Rate day and always 47avge night no pauses I am able keep med dosages low.

AM Diltiazem 120mg control H/Rate

PM Bisoprolol 2.5 control BP

PRADAXA 110mg x twice

and I have thyroxine to take daily without food early AM.

Perhaps your H/Specialist will change you to bisoprolol which is more appropriate for aFers.

They say use your technical equipment daily for news, games, replying to emails to keep your brain alert.

cheri jOY. 75. (NZ)

Finvola profile image
Finvola

My memory is flaky but cognitive function seems OK - by my judgment anyway. I have to whisper to myself why I am going to another room, otherwise mostly I cannot remember what I went there to do and stand like an idiot wondering what I came for. Maddening. I put this behaviour down to ageing, rather than AF but - who knows?

Forgetting words is worrying - and cringe-making - I recently forgot the word for something but could describe its function clearly and even give alternatives for it, like some sort of geriatric Thesaurus. I love word and logic puzzles and (easier) crosswords so I felt that lapse severely.

I think mental stimulation is vital to us 'senior' folk - I'm 80 btw - a hobby enjoyed - such as your keyboarding, new skills, old skills revisited and, for me, the comfort and memories of a beloved, crazy Border Collie.

One thing I have noticed as I age is the fluctuation in mental ability from one day to the next - a crossword which I can do most days will become an impossible task occasionally - and it isn't the difficulty level but a mental block.

Is AF contributing to all this? Probably not . . .

jeanjeannie50 profile image
jeanjeannie50 in reply toFinvola

I do crosswords too Finvola. I was scuppered this morning. I read the word minute as in being small, suddenly thought how do you spell minute relating to time, I couldn't fathom it out, my brain just went to mush and it worried me. I think the cure may be not to think too deeply and just write. Hesitate and wonder about spelling and it becomes confusing Well for me it does ! Collies are my favourite dogs. My dad always had them, they're so intelligent and loyal. I loved every one we had.

Jean

Finvola profile image
Finvola in reply tojeanjeannie50

I know that feeling Jean when it feels like you're in a blind alley and cannot figure anything out. We miss our lovely Jessie - no-one to give advice and (barking) guidance on every task, especially gardening. We've always had collies too and had years of joy with them.

Bagrat profile image
Bagrat

My husband has permanent AF and has a degree of "cognitive decline". If I talk quickly he cannot grasp my meaning, or if I put more than one name in a sentence. He has problems with nouns too, finding them, even common names like fridge and microwave.I feel my grasp of concepts is unchanged but going upstairs for something is lost by the time I get to the top and I rely heavily on lists.

Names of people do not stay in my brain either.

I do not blame AF, more the human condition!

Someone said re the losing reason why, when going from one room to another that it is God's way of making sure the elderly get a modicum of exercise!

GrannyE profile image
GrannyE in reply toBagrat

My father always said’if you have a bad memory you need strong legs’.

It’s the proverbial elephant in the room. We know there is apparently an association between AF and dementia but we prefer not to think about it!

I have mild cognitive problems which like many here, I attribute to ‘ageing’ rather than our AF. But ageing has to have an underlying cause, which may or may not be treatable.

So in my situation at 75 with permanent AF, I will continue the ACs, anti hypertensive and statin for as long as it is safe to do so.

Antioxidants and anti inflammatories are apparently important too. So too, attention to diet and weight, also modest exercise.

Intuitively it seems sensible to challenge our cognitive pathways, though I’m not aware of robust evidence of the benefits.

Mugsy15 profile image
Mugsy15

I knew AF causes cognitive decline but had forgotten.

Geoffa1 profile image
Geoffa1

I am coming up for three years post successful catheter ablation.And I have been participating in the OCEAN trial for some time.

pubmed.ncbi.nlm.nih.gov/294...

As part of the trial I get regular cognitive testing and brain MRI.

I was randomised to 15mg daily zarelto.

The purpose of the trial is to, amongst other things, be better placed to answer your challenging question!!

I am not sure how I am going in the trial. I think that is intentional.

Have I suffered cognitive decline since AFIB and is it better or worse through taking zarelto I guess I need to be smarter at statistics, or not be suffering cognitive decline to answer!!!

Probably doesn't answer your question, rather suggesting the experts are trying hard to be informed.

Geoff

GrannyE profile image
GrannyE

that and stroke are terrifying prospects which I try not to think about.

OldGrit profile image
OldGrit

I think you voice a worry shared by many. I have those days when I can remember my fifth birthday party in minute detail - but where did I put that screwdriver I had in my hand 5 minutes ago?

I noticed last year that the good Spanish I spoke when I worked for a few years in Spain seemed to come harder , then my wife became even harder to understand (!) …. strangely no one else.

As I have suffered from tinnitus for many years I have worn hearing aids which helps to some extent. As good as the NHS ones there are better and I’ve just invested my savings in a new top of the range pair and every has changed. I can hear my Spanish neighbours and friends again and now can respond. I can hear my wife talk again …she’s surprised as she enjoyed telling me I was in cognitive decline but I think she mumbles deliberately (that’s an entire different story) .

They say hearing loss is also related to cognitive decline so with AF, bradycardia and tinnitus related loss I’m making sure I take my ACs , keep my hearing aids up to date and keep on being engaged, curious and fit.

I’ve also got a pacemaker.

I do tests every six months as I’m in a trial and so far so good. They wanted to do a brain scan for the trial but my wires for my pacemaker aren’t mri proof because of their age but we’ve agreed they can have my brain when I no longer use it ( if I’m forced to watch more Masked Singer maybe) .

Czech_Mate profile image
Czech_Mate in reply toOldGrit

And those telephone numbers we can remember from our youth! I can recite without problem the phone number of my first girlfriend, but ask me my wife's phone number and I'd have to look at my phone.

Dollcollector profile image
Dollcollector in reply toCzech_Mate

Telephone numbers were shorter in the old days.😀

Singwell profile image
Singwell

Interesting post. Keep on with the piano playing and - if possible- sing along with it. Apparently playing and singing at the same time fires multiple regions in the brain. I'm 67 so do not yet have some of the experiences reported here but can share the following Beta blockers slowed me down and impaired my walking stamina and thought processes. I won't have them again by choice.

Depression and anxiety significantly impair cognitive function - I've experienced both and noticed the effects. Lots of us suffer from this due to the impact of AF on our lives.

Thyroid health is a big player in cognitive function too- I was subclinical hypothyroid for years and really thought I was 'losing it' until I started treatment.

Ppiman profile image
Ppiman

I have what seems similar, at 70. Goodness knows where it will lead - everyone has the same fears, no doubt. But I also have severe insomnia, too and a busy mind, with an anxious personality. My GP puts it all down to these things and you know, I think he's right. Stress, or a busy mind, or anxiety about the heart... all speed along the memory motorway lanes and trying to cross those is hard when a new thought occurs, a name we need, or a word, and so on.

My next door neighbour is now 88 years old and in the thirty years we have known her, Heather has been forgetful and fearful of where it will lead. She still is.

Steve

Dudtbin profile image
Dudtbin

there no hope for my husband and i then, he had a stroke last year and is worried all the time about his memory but mine is just as bad and i keep saying the wrong word, fridge when i mean oven or similar - we both have AF 🤔

Auriculaire profile image
Auriculaire

I think if you speak two languages getting them mixed up a bit sometimes is normal . I often forget words in English that I can remember the French equivalent for. I know my brain works unconsciously in French as I often catch myself thinking in French and I dream in both languages. It doesn't really bother me. Not like standing in front of the fridge and wondering what I'm supposed to be getting out of it! Or mislaying my glasses because I have taken them off to read something then wandered off without them. I don't think I absorb books like I used to . Kindles are handy for this . If you come across a character and can't remember who they are you can put their name into the search .My mother stopped watching dramas on tv as it was obvious she could not follow the plots anymore. My main beef nowadays is having to get up and go up to the tv to read the text messages the characters send each other. I curse the program makers for assuming that everybody has an enormous tv that they sit close to!

Czech_Mate profile image
Czech_Mate in reply toAuriculaire

Do you have a procedure for trying to find lost words or names? The more I try to concentrate on finding the word, the less it is likely to come. I try to let my brain "float in mid-air" which sometimes helps, the word or name pops up from somewhere.

Auriculaire profile image
Auriculaire in reply toCzech_Mate

I find it usually comes back later. I find it annoying that I forget the names of plants so when writing in my to do gardening book I have to write a description rather than the Latin name. I've never learnt the French names for most plants!

momist profile image
momist

I sympathise with your difficulty on the keyboard. I'm the same, musically. And, I so love listening to good music, especially piano and violin (no hope of playing one of those!). Many years ago I took weekly night school classes for guitar, after two years of that I could knock out two different tunes, rather poor in quality. I could never sing anything.

Cognitive decline? Yes, but at 74 I've been putting it down to age rather than the AF.

Czech_Mate profile image
Czech_Mate in reply tomomist

I've been trying the Beatles' "Banana Song". ( Banana, nana .... Hey Jude) 😉 . It was one of my brother's favourite songs, so I imagine him singing along.

JOY2THEWORLD49 profile image
JOY2THEWORLD49

Hi

Relate what you say is happening to your Dr.

I was in the office when my Mum was tested for Alzheimers.

Asked what day? Who is P.M? Her birthday ? Count back from 100.

Another a person will give you 3 items to remember. She talks on for 15 minutes then she says you for 3 items.

These tests are not good during a stressful time.

I hope you pass. Perhaps too much is going on and you are overloaded compared to having a clear head.

cheri jOY. 75. (NZ)

Czech_Mate profile image
Czech_Mate in reply toJOY2THEWORLD49

Yes, a question of getting the balance right, I think. Give the brain something new to do, but give it some r and r too.Not sure if I could name the NZ Prime Minister. 😏 You've recently had a change haven't you?

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply toCzech_Mate

Hi

Yes from Jacinda Ardern to the post CEO Air NZ.

Now Mr L................ National. I've forgotten. I'd rather have Jacinda. She got married to Nee's father Clarke Gable Journalist who joins the House Movers overnight programme.

I guess if one does not like a person, on purpose one forgets.

Cheri jOY

Alzheimer patients put keys in weird places like the sink.

Visigoth profile image
Visigoth

I’d just like to say that attending U3A groups is one of the best things you can do. Why not try some other groups? I do British History and Art Appreciation. And as it’s a mutual learning organisation I research and give talks in both groups about once a term. I believe it’s really important and really helpful, but having said that I do forget things much more easily now and have that familiar problem of not knowing what I went into a room for. It’s so hard to know what is ageing and what might be cognitive impairment but I have read some encouraging things about it being normal to forget things as you get older.

Cavalierrubie profile image
Cavalierrubie

Growing old is not for the faint hearted. My dear grandmother lived to the age of 96 and she was always fearful of losing her mind, so she read the newspaper every day, front to back. . My mother lived to the age of 94. and she used to sit and write poetry. Both had a sharp brain. I suffer from brain malfunction as others have said. I can begin a chore, and stop to do something else and completely forget what l was doing, until l go into the bedroom and see half of the ironing put away! I think it’s probably because l think of too many things at once. We have to accept decline, it’s one of the privileges of getting old. It’s not just the mind, its mobility as well, for some of us. What l used to do in one day, can now take three. It’s all good fun.😊

Mugsy15 profile image
Mugsy15

The regions of the brain affected earliest by cognitive decline are those in which short-term memory are 'stored'. These are the ones your brain is designed to fade out and discard. The long-term ones are safely locked away elsewhere, which is why many people in advanced stages of dementia can still talk freely about their childhood, and may even regress to that time.

It's a layman's way of explaining a deeply complex phenomenon, of course.

Don't worry about forgetting why you're in a room or forgetting names; that's perfectly normal as we age. A doctor friend told me once: "There's nothing wrong with forgetting where you put the car keys. It's looking at them and not knowing what they're for that might point to dementia becoming an issue."

LemonYogurtAlmonds profile image
LemonYogurtAlmonds in reply toMugsy15

Regarding “forgetting why you’re in a room”—there is the “doorway effect” and it is normal.

Jonathan_C profile image
Jonathan_C

I am 50, I went into persistent a-fib just over 2 years ago (shortly before my 48th birthday) - at the end of 2021.

There is so much of my life before that time - and often since - which I remember with the same vagueness that I did about the night before after getting really drunk when I was younger (like i know i spoke to a person, but cannot remember what was said).

I can also relate to not being able to find the words I need during conversations - and often in conversations with colleagues and clients when i am trying to describe something I am very knowledgeable about. I don't feel cognitively impaired, but struggle to access/recall memories ... or is that the same thing?

Sustainedvtach270 profile image
Sustainedvtach270

Great post! I am on beta blocker Sotalol 80g twice daily and blood thinner Xarelto 20mg. Near 60, sometimes I also forget what I am looking for in a room. Nowdays with all the phone numbers saved in our cell phone, it is normal not to remember the numbers. Speaking foreign languages should help, my native language is French, I have lived more than 30 years in the US, and I am also fluent in Spanish. Diet is important, eating non processed food, plant based diet, and exercise for those that can. I walk 10000 steps daily and also swim 🏊‍♀️ almost every day. Staying active is very important, we should try to move every hour. I am also working full time.

JOY2THEWORLD49 profile image
JOY2THEWORLD49

Hi

Mr Christopher Luxon PM National.

Cheri JOY

Snowgirl65 profile image
Snowgirl65

I try various things too to increase my gray matter -- including getting a keyboard -- but find I can't remember a thing from my adolescent piano classes!

Sweetmelody profile image
Sweetmelody

What meds are you on? If any, look to them first. I’ve been on metroprolol (tartrate and succinate), diltiazem, dabigatran, apixaban, amiodarone (ugh!), and now clopidogrel and aspirin post 2nd ablation and Watchman implant.

ALL of these drugs cause me brain fog, with amiodarone the worst offender and metoprolol a close second. I’ve experienced a lifting of the fog each time I stop any of these drugs, however temporarily. Stopping amiodarone and switching to clopidogrel cleared my head within two days— not completely, but I’m hoping when I stop the clopidogrel in 3 months (following post-Watchman implant protocol), and get all these drugs out of my system and have a normal heart rate and stay in rhythm, my clear head will return. That includes getting off all DOAC’s, which I believe have some minor brain fog side effects—which are not mentioned in the drug literature.

I’ll also mention that both tachycardia and bradycardia bring about brain sluggishness in me. AF is the cause of the tachycardia. Drugs are the cause of the bradycardia. I can’t think with normal speed and clarity and memory when my heart rate is out of the normal range if 60-100. Nor do I feel my normal emotional equanimity. Rate and rhythm — so precious. Some people seem to manage it on drugs without brain fog. I am not one of them.

secondtry profile image
secondtry

Mmmm...interesting. AF might affect cognitive function indirectly as well.

I am suspect pre - AF feelings or Sleep Apnoea are waking me up at night and that isn't making my days any easier. Also anxiety levels.

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