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Systematic review and meta-analysis
Atrial fibrillation is associated with an increased risk of cognitive impairment and dementia with or without a history of clinical stroke
  1. Paola Forti
  1. Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
  1. Correspondence to: Dr Paola Forti
    Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, Bologna, 40138, Italy; paola.forti{at}unibo.it

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Commentary on: Kalantarian S, Stern TA, Mansour M, et al. Cognitive impairment associated with atrial fibrillation: a meta-analysis. Ann Intern Med 2013;158(5 Pt 1):338–46.

Context

Atrial fibrillation (AF) is the most common cardiac arrhythmia in clinical practice. The estimated US prevalence of 2.7–6.1 million is expected to increase to 5.6–12.1 million by the middle of the current century. In addition, AF prevalence dramatically increases with age: <1% in individuals aged 50–59 years are affected, whereas about 10% of those aged 80–84 years and 11–18% of those ≥85 years have AF.1

Cognitive impairment with and without dementia is also a common condition in older age and is associated with higher mortality.2 Cognitive impairment is frequently associated with AF, but the rationale of this relationship is still controversial, especially in the absence of stroke.

This meta-analysis by Kalantarian and colleagues summarises …

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