Atrial fibrillation (AF) is the most common form of arrhythmia in the elderly population and increases stroke risk by a factor of 4- to 5-fold. There is increasing evidence to suggest that incident AF may contribute to the development of dementia, independent of overt stroke. In particular, relatively younger patients with AF are more prone to dementia development than older patients with AF. Evidence is accumulating regarding the possible treatment strategies for preventing dementia in patients with AF. Oral anticoagulation may be effective for reducing the risk of dementia, even in patients with low stroke risks. Among oral anticoagulants, the use of non-vitamin K antagonists have been associated with a considerably decreased risk of dementia than warfarin. Moreover, successful catheter ablation for AF has also been associated with decreased dementia risk compared to medical therapy, suggesting that restoration of sinus rhythm, and not the ablation procedure itself, as the important mechanism in the prevention of AF-associated dementia. Among midlife patients with AF, there appeared to be a U-shaped association of blood pressure (BP) and a linear association of hypertension with dementia risk. A BP of 120 to 129/80 to 84 mmHg has been identified as the optimal range. Finally, integrated management of AF was associated with a reduced risk of dementia in AF patients.

中文翻译：

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预防房颤患者痴呆症。

心房纤颤（AF）是老年人群中最常见的心律不齐形式，可使中风风险增加4到5倍。越来越多的证据表明，事件性房颤可能独立于明显的中风而促进痴呆的发展。尤其是，相对年轻的房颤患者比年长的房颤患者更容易出现痴呆症。关于预防房颤患者痴呆的可能治疗策略的证据越来越多。口服抗凝药可能有效降低痴呆症的风险，即使在中风风险低的患者中也是如此。在口服抗凝剂中，与维生素A相比，使用非维生素K拮抗剂可显着降低痴呆症的风险。而且，与药物治疗相比，成功的房颤导管消融术还与痴呆症风险降低相关，这表明窦律的恢复而非消融过程本身是预防房颤相关痴呆症的重要机制。在中年房颤患者中，似乎血压呈U型关联，高血压与痴呆风险呈线性关联。120至129/80至84 mmHg的BP被确定为最佳范围。最后，房颤的综合管理与房颤患者痴呆风险的降低有关。似乎血压呈U型关联，高血压与痴呆症风险呈线性关联。120至129/80至84 mmHg的BP被确定为最佳范围。最后，房颤的综合管理与房颤患者痴呆风险的降低有关。似乎血压呈U型关联，高血压与痴呆症风险呈线性关联。120至129/80至84 mmHg的BP被确定为最佳范围。最后，房颤的综合管理与房颤患者痴呆风险的降低有关。