Correlation between cerebral small vessel disease burden and risk of cognitive impairment in elderly atrial fibrillation patients
ZHOU Xiangyu
ZHANG Can
Abstract：Objective To investigate the relationship between burden of cerebral small vessel disease(CSVD)and cognitive impairment in the elderly with atrial fibrillation(AF),and to evaluate its potential regulatory effectiveness.Methods A total of 163 non-stroke patients with AF treated in our hospital from May 2021 to March 2024 were enrolled and divided into a cognitively normal group(122 cases)and a cognitively impaired group(41 cases)according to the results of Montreal cognitive assessment(MoCA)and mini-mental state examination(MMSE).Baseline data and imaging indicators were collected,and the total burden of CSVD was calculated.Pearson correlation analysis was used to analyze the correlation between the CSVD burden and cognitive impairment.Multivariate logistic regression analysis was employed to identify the risk factors of cognitive impairment in elderly AF patients.Results The cognitively impaired group had significantly advanced age and larger ratio of smoking,but shorter years of education and lower MoCA score than the cognitively normal group(P＜0.05,P＜0.01).Obviously more lacunar infarcts,higher white matter hyperintensities(WMH),higher total burden score,and larger ratios of cerebral microbleeds,brain atrophy and high-grade enlarged perivascular space(EPVS)were observed in the cognitively impaired group than the cognitively normal group(P＜0.05,P＜0.01).The total burden score of CSVD was negatively correlated with MoCA score(r=-0.425,P=0.000).Multivariate logistic regression analysis showed that age,years of education,basal ganglia WMH and total burden score were independent risk factors for cognitive impairment in elderly AF patients(P＜0.05,P＜0.01).After adjusting for age and years of education,multivariate logistic regression analysis still revealed that basal ganglia WMH(OR=3.140,95％CI:1.935～5.094,P＜0.01)and total burden score(OR=12.683,95％CI:4.167～38.608,P＜0.01)were risk factors for cognitive impairment in elderly AF patients.Conclusion The CSVD burden is related to cognitive impairment in elderly AF patients,and preventing the progression of CSVD may reduce the incidence of cognitive impairment.
Keywords：cerebral small vessel diseasesatrial fibrillationcognition disordersmagnetic resonance imaging
Publication Date：2025-12-15
Online Publishing Date：2025-12-29(First online date of this platform, not the publication date of the document)
Pages：5( 1693-1697 )