Introduction: Atrial fibrillation (AF) is the most common arrhythmia globally in adults and its prevalence increases with age. The incidence of mild cognitive impairment (MIC) also increases with age. Both MCI and AF share important risk factors.
Aims: This study aimed to examine the relationship between MCI and AF through a phased approach. Phase one was a scoping review, and phase two of the ALERT project was a cross-sectional study.
Research methods and sample: This scoping review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMAScR). The cross-sectional study opportunistically screened 214 participants for MCI and AF in a podiatric community setting in the West of Ireland.
Key findings: The scoping review included 38 studies. Across the included articles, the mean prevalence of MCI in patients with AF was 37.84%. The main proposed pathologic mechanisms linking MCI and AF from the articles were white matter lesions, cardiovascular risk factors, silent cerebral infarction and cerebral hypoperfusion. The most common tools used in these studies to identify MCI were a battery of cognitive tests and the MoCA test. Phase two opportunistically screened 214 patients for AF and MCI. The prevalence of AF in this cohort was 15.4%. In total, 50 (23.4%) participants had MoCA scores less than 26 indicating MCI and 7 (3.2%) participants had MoCA scores less than 17 indicating moderate cognitive impairment. A statistical significance was found; those with arrhythmia had lower MoCA scores indicative of cognitive impairment (P=0.025).
Conclusion: This project highlighted the relationship between MCI and AF. This research shows the critical role that podiatrists can play in the early detection of these conditions. Future studies could further evaluate the role of podiatrists in opportunistic screening for arrhythmia and particularly examine the prevalence of AF and MCI in a more racially diverse population. ❑
