Relationship between atrial fibrillation and cognitive decline in individuals aged 80 and older : a narrative review

Background:Atrialfibrillation (AF) and dementia are largely prevalent and incident in progressively older sub-jects, suggesting a link between the two conditions. While in the general population there are severalfindingssupporting a causal relationship between AF and dementia, it is unclear whether or not this association is stillpresent in individuals aged 80 and older.Results:So far, the few studies that analysed this issue did not provide enough evidence supporting the causativerole of AF in increasing the risk of cognitive decline or dementia in patients aged 80 and older. Conversely, a rel-evant roleofoptimalanticoagulation controlin determininga significantreduction intheriskofcognitive declineis suggested, in AF subjects aged 80 years or older.Conclusions:Further data, coming from population-based studies specifically investigating very old individualsand based upon large samples and comprehensive cognitive assessments, are needed to fully elucidate the rela-tionship between AF and dementia in very old individuals.