Atrial fibrillation and dementia: an unresolved ‘Folie à Deux’

[...]this study adds to the literature by suggesting a stroke/TIA-independent contribution of AF to dementia. The association of AF to CVA/TIA depending on the thromboembolic risk profile (CHA2DS2-VASc score) is well known and anticoagulation accordingly has its place in current guidelines.5 6 The association of not only clinical, but subclinical CVA/TIA to the development of dementia has also been established.7 8 The lack of cerebral imaging in most of the included studies renders it difficult to exclude subclinical CVA as a cause of dementia development. [...]care should be taken when assuming an association between AF and dementia independent of repetitive cerebral thromboemboli due to AF leading to both clinical and silent CVA. [...]diagnostic criteria for dementia and AF were different among the included studies, so that qualitative heterogeneity is possible. [...]the mechanisms underlying this association should be better understood considering AF as a systemic disease.