OBJECTIVES To evaluate the clinical characteristics and the long-term outcome of atrial fibrillation (AF) patients with dementia and history of syncope or falls. DESIGN Observational: analysis of a prospective registry. SETTING AND PARTICIPANTS Between 2012 and 2016, the Syncope and Dementia Registry enrolled patients in 12 geriatric departments. Follow-up evaluation was at 12 months. MEASURES Clinical, functional, and cognitive assessment. RESULTS Of the 522 patients (women, 62.1%; Mini-Mental State Examination 17 ± 6), 26.4% have or presented an AF history. Patients with AF were older (85 ± 6 vs 83 ± 6 years, P = .012), with higher heart rate (78 ± 17 vs. 73 ± 14 bpm, P < .001), prescribed drugs (6.9 ± 2.9 vs 5.9 ± 2.7, P < .001), and an increased number (3.9 ± 2.0 vs 3.0 ± 1.8, P < .001) and severity of comorbidities. Oral anticoagulant therapy was underprescribed (39.9%). Cardiac syncope was more frequently diagnosed (18.8 vs 4.9%, P < .001). At multivariate analysis, AF patients were characterized by advanced age, a higher severity of comorbidities, a greater number of prescribed drugs, an increased heart rate, and a more frequent presence of cardiac symptoms. One-year mortality differed little between patients with and without AF (27.7 vs 22.1%, P = .229). In the arrhythmia group, multivariate predictors of prognosis were disability (number of lost BADLs; P = .020) and a higher heart rate (P = .006). CONCLUSIONS AND IMPLICATIONS AF and postural stability-related issues often co-exist in persons with dementia. This complex of conditions is associated with an intricate clinical picture, underprescription of oral anticoagulants, and high long-term mortality. Future studies are needed to evaluate the effects of therapy optimization in this population.

中文翻译：

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老年晕厥和痴呆患者的心房颤动：来自晕厥和痴呆登记处的见解

目的 评估心房颤动 (AF) 痴呆和晕厥或跌倒史患者的临床特征和长期预后。设计观察：前瞻性登记分析。设置和参与者 2012 年至 2016 年期间，晕厥和痴呆登记处招募了 12 个老年科的患者。随访评估为 12 个月。措施 临床、功能和认知评估。结果 522 名患者（女性，62.1%；简易精神状态检查 17 ± 6）中，26.4% 有或有 AF 病史。房颤患者年龄较大（85 ± 6 vs 83 ± 6 岁，P = .012），心率更高（78 ± 17 vs. 73 ± 14 bpm，P < .001），处方药物（6.9 ± 2.9 vs 5.9 ± 2.7, P < .001)，并且合并症的数量和严重程度增加（3.9 ± 2.0 vs 3.0 ± 1.8, P < .001）。口服抗凝治疗处方不足（39.9%）。心脏性晕厥的诊断率更高（18.8% vs 4.9%，P < .001）。在多变量分析中，房颤患者的特征是高龄、合并症的严重程度更高、处方药数量更多、心率加快和心脏症状出现频率更高。有和无 AF 患者的一年死亡率差异很小（27.7% vs 22.1%，P = .229）。在心律失常组中，预后的多变量预测因子是残疾（丢失 BADL 的数量；P = .020）和较高的心率（P = .006）。结论和意义 AF 和姿势稳定性相关问题通常在痴呆症患者中并存。这种复杂的情况与复杂的临床表现、口服抗凝剂处方不足和长期高死亡率有关。