Abstract
ObjectiveTo compare cognitive profiles and dementia severity among older patients with atrial fibrillation (AF), with and without ischemic stroke (IS), and to evaluate the contribution of vascular burden to global cognitive status.MethodsThis cross-sectional clinical study included 124 patients aged ≥55 years who were stratified into three groups: AF without IS (n = 50), AF with IS (n = 25), and IS without AF (n = 49). Global cognitive status was assessed using ordinal categories derived from the Mini-Mental State Examination (MMSE). Attention and working memory were additionally evaluated using the Information-Memory-Concentration (IMC) test derived from the Blessed Dementia Scale. Vascular burden was assessed using the Hachinski Ischemic Score (HIS). Group differences were analyzed using appropriate statistical tests, and predictors of worse cognitive status were examined using ordinal logistic regression.ResultsPatients with combined AF and IS demonstrated a trend toward a less favorable cognitive profile and higher vascular burden compared with patients with AF alone or IS alone. The proportion of female participants differed significantly across groups (p = 0.022), whereas age category and educational level were comparable. In multivariable ordinal logistic regression analysis, higher Hachinski Ischemic Score independently predicted worse global cognitive status (OR 1.79, 95% CI 1.42-2.25; p < 0.001) after adjustment for age, sex, education, and major vascular risk factors.ConclusionsVascular burden plays an important role in cognitive impairment among older patients with atrial fibrillation, particularly when accompanied by ischemic stroke. Incorporating vascular burden assessment into routine clinical evaluation may facilitate earlier recognition and characterization of cognitive impairment in aging populations.