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. 2018 Mar 18;20(9):1399–1421. doi: 10.1093/europace/euy046

Table 10.

Interventions to be considered for prevention of cognitive dysfunction in atrial fibrillation patients

Pharmacological interventions

  •  • In relation to AF management:

  •   – Oral anticoagulation (early identification of appropriate candidates, improving drug adherence, avoiding warfarin in those with poor TTR, and optimal TTR management)

  •   – Rhythm control

  •   – Antihypertensive treatment

  •   – Treatment of concomitant heart failure

  •  • Non-specific pharmacological interventions:

  •   – Glycaemic control

  •   – Hormone replacement therapy

  •   – Avoid aspirin therapy unless specific clinical indication present

  •  • Alzheimer’s disease-specific pharmacological interventions

Multifactorial vascular risk factor management

  •  • Targeting blood pressure, cholesterol, diabetes, sleep apnoea, obesity via diet, medication, smoking cessation, and physical activity

Nutritional interventions

  •  • Low levels of vitamin D and B12, and folate increase risk, but the value of supplementation remains unproven. Calcium supplementation in women has been associated with increased dementia risk.200–202 The value of modulating cognitive function based on educational interventions is uncertain.

  •  • Weight loss in obesity203

Others

  •  • Cognitive activities or training

  •  • Physical exercise

  •  • Multi-domain interventions

AF, atrial fibrillation; TTR, time in therapeutic range.