Sex differences in risk of mild cognitive impairment and dementia in population with atrial fibrillation

Abstract

Background: Atrial fibrillation (AF) is one of the most common arrythmia in adults and is considered a major issue from a global health perspective. Dementia, being among the top 10 leading causes of death in the world, is expected to increase significantly in numbers over the next decades. The latest research suggests that there is an association between AF and mild cognitive impairment (MCI), all-cause dementia, and possibly the two most common subtypes of dementia - Alzheimer´s dementia (AD) and vascular dementia (VaD). Nevertheless, the role of sex differences in the AF population has received little research attention and needs to be reviewed.

Aim: To assess possible sex differences in the association between AF and MCI or all-cause dementia, including AD and VaD, in an AF population.

Methods: A literature review was conducted. A literature search over the last 10 years was constructed in PubMed: one search using Mesh terms and one with the use of relevant search words for MCI, dementia, and subtypes of dementia in the title or abstract. Inclusion and exclusion criteria were implemented in both searches.

Results: 15 studies were included in the literature review, two meta-analyses and 13 cohort studies. Two studies found that women with AF had a higher risk for developing MCI compared to men. Seven studies found women with AF having a higher risk for developing all-cause dementia than men. Three studies found women with AF having a higher risk for developing AF compared to men, and three studies found men with AF having a higher risk for developing VaD compared to women. Five studies found no significant sex differences.

Conclusion: The reviewed literature suggests that the female sex may be a risk factor for developing all-cause dementia in an AF population. Contradicting results were found regarding AD and VaD. Sparse literature regarding MCI makes the supposed higher risk for the female sex inconclusive. More research regarding sex differences is needed to assess the possible association between AF and MCI as well as dementia subtypes.

Background: Atrial fibrillation (AF) is one of the most common arrythmia in adults and is considered a major issue from a global health perspective. Dementia, being among the top 10 leading causes of death in the world, is expected to increase significantly in numbers over the next decades. The latest research suggests that there is an association between AF and mild cognitive impairment (MCI), all-cause dementia, and possibly the two most common subtypes of dementia - Alzheimer´s dementia (AD) and vascular dementia (VaD). Nevertheless, the role of sex differences in the AF population has received little research attention and needs to be reviewed.

Aim: To assess possible sex differences in the association between AF and MCI or all-cause dementia, including AD and VaD, in an AF population.

Methods: A literature review was conducted. A literature search over the last 10 years was constructed in PubMed: one search using Mesh terms and one with the use of relevant search words for MCI, dementia, and subtypes of dementia in the title or abstract. Inclusion and exclusion criteria were implemented in both searches.

Results: 15 studies were included in the literature review, two meta-analyses and 13 cohort studies. Two studies found that women with AF had a higher risk for developing MCI compared to men. Seven studies found women with AF having a higher risk for developing all-cause dementia than men. Three studies found women with AF having a higher risk for developing AF compared to men, and three studies found men with AF having a higher risk for developing VaD compared to women. Five studies found no significant sex differences.

Conclusion: The reviewed literature suggests that the female sex may be a risk factor for developing all-cause dementia in an AF population. Contradicting results were found regarding AD and VaD. Sparse literature regarding MCI makes the supposed higher risk for the female sex inconclusive. More research regarding sex differences is needed to assess the possible association between AF and MCI as well as dementia subtypes.