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Vorhofflimmern und kognitive Störung – Bedeutung für die Geriatrie

Atrial fibrillation and impairment of cognition—importance for geriatrics

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Zusammenfassung

Eine unabhängige Assoziation zwischen Vorhofflimmern und kognitiver Einschränkung ist nach der jetzigen Studienlage wahrscheinlich. Mehrere Pathomechanismen scheinen ursächlich zu sein: Insbesondere Embolien bewirken über die Verursachung klinisch inapparenter Hirninfarkte eine Verschlechterung des kognitiven Status, aber auch Hypoperfusion und möglicherweise konsekutive Atrophien der grauen Substanz können eine Rolle spielen. Es gibt Hinweise, aber noch keine ausreichende Evidenz für vorhandene protektive Effekte von Antikoagulation, Rhythmuskontrolle und evtl. von Frequenzregulation.

Abstract

According to the current study situation an independent association between atrial fibrillation and cognitive impairment is likely. Several pathomechanisms seem to be causative: embolisms in particular appear to cause clinically inapparent cerebral infarction and thus a deterioration of cognitive status but hypoperfusion and possibly subsequent atrophy of the gray matter can also play a role. There are indications but not yet sufficient evidence for protective effects of anticoagulation, rhythm control and possibly frequency regulation.

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Förderung

Die Forschung von R. Schnabel gefördert durch den European Research Council (ERC) unter dem European Union Horizon 2020 Research and Innovation Programm (Grant Agreement No 648131 und Grant Agreement No 847770 (AFFECT-EU)) sowie durch das Deutsche Zentrum für Herz-Kreislauf-Forschung e. V (DZHK, 81Z1710103).

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Authors and Affiliations

  1. Klinik für Geriatrie, Bethesda Krankenhaus Hamburg Bergedorf, Glindersweg 80, 22029, Hamburg, Deutschland

    Alexander Rösler

  2. Universitäres Herz- und Gefäßzentrum Hamburg, Klinik und Poliklinik für Kardiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

    Renate Schnabel

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  1. Alexander Rösler
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Correspondence to Alexander Rösler.

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Interessenkonflikt

A. Rösler erhielt Vortragshonorare von Daiichi-Sankyo. R. Schnabel erhielt Vortragshonorare von BMS/Pfizer.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Rösler, A., Schnabel, R. Vorhofflimmern und kognitive Störung – Bedeutung für die Geriatrie. Z Gerontol Geriat 54, 704–707 (2021). https://doi.org/10.1007/s00391-020-01754-x

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  • DOI: https://doi.org/10.1007/s00391-020-01754-x

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