Women with Atrial Fibrillation Face Greater Cognitive Decline, Study Finds
Researchers from Emory University in Atlanta report that women with atrial fibrillation experience cognitive decline more rapidly than men. The findings appear in a study published in Alzheimer’s & Dementia: Journal of the Alzheimer’s Association.
Atrial fibrillation is the most common cardiac rhythm disorder, affecting more than 40 million people globally. Individuals with this condition carry a fivefold higher risk of stroke compared with those without atrial fibrillation. Anticoagulant therapy can significantly reduce that risk, highlighting the importance of timely treatment.
The new study analyzed data from 43,600 participants enrolled in the National Alzheimer’s Coordinating Center (NACC) study, with data collected since 1984. At baseline, 4,593 participants, or about 11%, had atrial fibrillation.
Among women with atrial fibrillation, the likelihood of presenting mild cognitive impairment or dementia at the study’s outset was triple that of women without atrial fibrillation. In men, atrial fibrillation also raised the risk of cognitive impairment, but to a lesser degree.
The differences extended beyond prevalence. Over a median follow-up of four years, 30% of participants developed severe cognitive impairment, and 21% progressed to dementia. Women with atrial fibrillation showed a higher risk of more serious dementia and faster disease progression, whereas the increase in risk for men was smaller and more modest.
These analyses adjusted for a range of confounding factors that can influence outcomes, including age, gender, race, education, body mass index, smoking status, depression, hypertension, diabetes, high cholesterol, heart failure, prior stroke, and sleep apnea.
Experts noted that symptoms of atrial fibrillation in women are frequently overlooked by healthcare professionals or attributed to stress or anxiety. This can delay diagnosis and treatment, allowing the condition to progress unchecked compared with men, who are more often diagnosed promptly.
Delayed diagnosis means women may receive anticoagulants later in the course of the disease, increasing the potential for blood clots that travel to the brain and contribute to cognitive decline. The authors call for heightened awareness and earlier evaluation of atrial fibrillation in women to mitigate these downstream risks.
Practical steps to support brain health and potentially slow aging include getting sufficient sleep, reducing risky lifestyle habits, following a balanced diet, staying physically active, and maintaining ongoing education and mental stimulation.
In the broader context, the study underscores the need for sex-specific research in cardiovascular and cognitive health, and for clinicians to consider gender differences when diagnosing and treating atrial fibrillation. The work adds to a growing body of evidence linking cardiovascular conditions with cognitive outcomes and highlights the value of early intervention and consistent management—especially for women who may face delayed recognition of symptoms.
This summary reflects findings from the cited study and related literature on the topic. Further information and detailed methodology are available from the research team and associated institutions. (Citation: Emory University and Alzheimer’s Association, 2024 study in Alzheimer’s & Dementia journal.)
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