Deseret News
Published: Friday, May 15, 2009 12:29 a.m. MDT

Link to Alzheimer's
By Carrie A. Moore

If you've ever had a heart flutter that wasn't caused by romance, take note: People under 70 with atrial fibrillation are 130 percent more likely to develop Alzheimer's disease than those without it.

That's according to researchers at Intermountain Medical Center, who are presenting their findings today to thousands of heart specialists during the annual meetings of the Heart Rhythm Society in Boston.

Dr. T. Jared Bunch, an IMC cardiologist and lead researcher, said the study includes data from more than 37,000 Intermountain Healthcare patients. "To our knowledge, this is the first large-population study to clearly show that having atrial fibrillation puts patients at greater risk for developing Alzheimer's disease."

While the known risk factors for Alzheimer's are genetics, age and family history, heart health has long been suspected to play a role but has not been directly linked to the disease, he said. The new study bolsters that connection.

"I wouldn't call it predictive. We can't say that atrial fibrillation causes Alzheimer's, but we can say those with AF (atrial fibrillation) are at higher risk, and once they get it, the combined disease state worsens outcomes significantly," Bunch said.

Researchers were surprised, he said, that "the youngest patients were at highest risk. It suggests that AF is playing a role in the risk compared to other factors in aging."

Atrial fibrillation is an irregular and often rapid heart rate, and can cause heart palpitations, chest discomfort, shortness of breath and weakness. It is often caused by high blood pressure, sleep apnea or heart disease and leads to blood pooling in the heart, where it can clot and cause a stroke.

According to the American Heart Association, about 2.2 million Americans have been diagnosed with the disorder, which is the most common heart rhythm problem. In people with the disorder, the heart's two small upper chambers quiver instead of beating effectively, allowing blood to pool and even clot.

Early, aggressive treatment of high blood pressure and sleep apnea can either reduce or eliminate AF in some patients, Bunch said. Atrial fibrillation episodes can come and go, and in some cases, people are not even aware their heart is beating irregularly, a condition called "silent" AF.

"When it comes and goes, it's much more responsive to medications and ablative therapies," he said, adding that once AF becomes chronic, the effectiveness of treatment decreases.

Understanding that there is a correlation between atrial fibrillation and Alzheimer's in younger people will allow doctors and patients to either work at preventing the disorder, or treating it early when a diagnosis has been made, he said. Picking up "silent" cases would require testing that's not normally done on younger people, Bunch said.

The study also found:

Patients of any age with AF were 44 percent more likely to develop dementia than patients without the heart disorder.

Younger patients with AF were at higher risk of developing all types of dementia, particularly Alzheimer's.

Patients who have both AF and dementia were 61 percent more likely to die during the study period than dementia patients without the rhythm problem.

Younger AF patients with dementia may be at higher risk of death than older AF patients with dementia.

Alzheimer's disease affects approximately 5.3 million Americans and is the most common form of dementia, accounting for 60 percent to 80 percent of all dementia cases. It is the sixth leading cause of death in the United States.

The study was conducted using five years of data from the Intermountain Heart Collaborative Study, a vast database created with information from hundreds of thousands of patients treated at Intermountain Healthcare hospitals. Data from 37,025 patients was included, and of that group, 10,161 developed AF and 1,535 developed dementia during the study period.

"Now that we've established this link, our focus will be to see if early treatment of atrial fibrillation can prevent dementia or the development of Alzheimer's disease," said Dr. John Day, a cardiologist and director of heart rhythm services at IMC. Day is a co-author of the study.

Bunch expects the findings will spur additional studies to confirm their conclusions and to examine whether early intervention with AF patients can actually alter the outcome and prevent the onset of Alzheimer's.

http://www.deseretnews.com/article/705303653/Link-to-Alzheimers.htm...http://www.deseretnews.com/article/705303653/Link-to-Alzheimers.htm...">

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The above article finding thanks to Rooster at cpaptalk.com
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This article raises the question in my mind of just when an occasional heart flutter fits the definition and Dx of Atrial Fibrillation. The first sentence of the article "could" be alarming - if one were prone to being easily alarmed. I know I've had these fast flutters on occasion for several years, often enough at one time to mention them to my family doctor. He was unconcerned and I wasn't all that concerned so much as curious when I mentioned them and questioned him. I don't experience them near as often since starting xPAP and we do have to keep in mind that I have COPD which may have some influence. None of my "flutters" ever lasted long enough that they could allow any blood clotting to my knowledge which is why I really have to question that first sentence and think it somewhat misleading. Maybe I'm wrong.

I'm curious as to just how the test for and Dx AF. Especially the "silent" AF. A Holter monitor occured to me - but - if the "flutters" are just occasional as mine were/are it would probably take a week, maybe more, of wearing a Holter to register one that I would be aware of. And I doubt a week would be long enough now since starting xPAP. (When I say occasonal I MEAN occasional).

A sleep tech once mentioned to me after looking at my xPAP download that I might want to ask my sleep doctor the next time I saw him about the somewhat frequent bradycardia he saw on the graphs. By the time I saw the sleep doctor again, of course, I forgot to ask that question. Early morning I have spent a good half hour or more w/the heart rate in the mid to high 50s.