Is There a Connection Between Afib and Dementia or Alzheimer’s?

Five Key Points from Dr. Tordini

• Afib Increases Risk of Stroke and Silent Brain Injury – Afib can lead to blood clots that cause strokes or “silent” micro strokes, both of which damage brain tissue and raise the risk of dementia.
• Reduced Blood Flow to the Brain May Contribute to Cognitive Decline – The irregular heart rhythm in Afib can gradually reduce oxygen supply, leading to impaired cognitive function and memory.
• Chronic Inflammation May be a Link Between Afib and Alzheimer’s – Afib is associated with systemic inflammation, a process also believed to play a role in the development of Alzheimer’s disease and other dementias.
• Afib and Dementia Share Common Risk Factors – Conditions like hypertension, diabetes, obesity, and sleep apnea contribute to Afib and cognitive decline, amplifying overall risk.
• Treating Afib May Help Protect Brain Health – Managing Afib with medications, blood thinners, or rhythm control procedures may reduce the risk of dementia, especially when combined with consistent cardiovascular care.

If this interests you, read on!

Atrial fibrillation, or Afib, is the most common type of heart rhythm disorder, characterized by an irregular and often rapid heartbeat. Instead of contracting in coordination, the heart’s upper chambers (the atria) quiver or fibrillate. This irregular rhythm can lead to poor blood flow, allowing blood to pool in the left atrial appendage and form clots. These clots can travel to the brain, causing strokes, which are a well-known risk factor for vascular dementia.

However, even in the absence of a major stroke, people with Afib are increasingly found to be at higher risk for silent strokes—tiny, symptomless brain injuries that accumulate over time.

These subtle injuries can damage brain tissue and contribute to memory problems, confusion, and executive dysfunction. Over time, their cumulative effect may contribute to various forms of dementia, including Alzheimer’s disease.

Inflammation, Oxygen, and Other Contributing Factors

Beyond strokes and clots, several other mechanisms may explain the link between Afib and dementia. For example, Afib is associated with chronic low-level inflammation, which can hasten neurodegenerative conditions like Alzheimer’s. Further, the irregular heart rhythm may cause reduced cardiac pumping capability, resulting in less oxygen-rich blood being delivered to the brain. Over time, this decrease in cerebral “food” can impair brain health and cognitive function.

Lastly, many people with Afib have other conditions that also raise the risk of dementia, such as high blood pressure, diabetes, obesity, and sleep apnea. These shared risk factors may partly explain the connection, but even after adjusting for them, many studies still show a higher risk of cognitive decline in individuals with Afib.

Can Treating Atrial Fibrillation (Afib) Help Preserve Brain Health?

Effective treatment of Afib—especially treatments that restore and maintain a normal heart rhythm—may lower the risk of developing dementia. Blood thinners (anticoagulants), such as warfarin or newer oral anticoagulants, reduce stroke risk. Rhythm control strategies, including medications and procedures such as catheter ablation or pulsed-field ablation, may also improve long-term cognitive outcomes.

It’s also important to recognize that managing overall cardiovascular health—keeping blood pressure in check, treating diabetes, maintaining a healthy weight, and getting good sleep—can benefit both heart rhythm and brain function.

The Bottom Line

While atrial fibrillation does not seem to directly cause dementia, it appears to increase the risk of cognitive decline. The connection is almost surely multifactorial, resulting from strokes, silent brain injury, inflammation, and reduced blood flow to the brain.

For individuals living with Afib, especially older adults, it’s important to treat the condition proactively—not only to prevent heart complications and stroke but also to support long-term brain health. If you or a loved one has Afib, talk to an experienced electrophysiologist like Dr. Tordini about comprehensive treatment options and how they may help preserve cognitive function as you age.

Dr. Tordini is a part of Florida Medical Clinic Orlando Health