Atrial fibrillation is an independent risk factor for the development of cognitive impairments. Regular coffee consumption has shown cognitive benefits in healthy individuals. Whether regular consumption reduces cognitive decline in vulnerable patients is controversial. In new research, scientists from the University Hospital Zurich and elsewhere investigated the association in elderly people with atrial fibrillation.
Coffee consumption in patients with atrial fibrillation may be associated with improved cognitive performance and reduced inflammatory markers. Image credit: Sci.News.
Atrial fibrillation (AF) is the most frequent type of cardiac arrhythmia, affecting 5% of the population over 65 years old and increasing exponentially thereafter.
AF results in a 5‐fold increased risk of thromboembolic stroke. Furthermore, it represents an independent risk factor for developing mild cognitive impairment and dementia with odds ratios of 2.3 to 5.8 respectively.
AF is not only associated with higher incidence of vascular cognitive impairment and increased size and number of strokes, but also with an increased risk for Alzheimer’s disease.
The 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation noted that abstaining from caffeine to prevent heart rhythm disturbances is of no benefit to people with AF.
The guideline also notes that abstaining from coffee could reduce symptoms in patients who report that caffeine triggers or worsens their AF symptoms, which can include rapid heartbeat, dizziness, fatigue and more.
“It is known that regular coffee consumption benefits cognitive performance among healthy people,” said Dr. Massimo Barbagallo, a researcher at the University Hospital Zürich.
“The most frequent cardiac arrhythmia, atrial fibrillation, is known to independently increase the risk of dementia.”
“Thus, the question is whether coffee might offset the increased risk of cognitive impairment in people with AF.”
The Swiss Atrial Fibrillation Cohort Study (Swiss-AF) follows more than 2,400 people in Switzerland diagnosed with AF.
Patients were enrolled between 2014 and 2017, completed several cognitive tests, and reported how many cups of caffeinated coffee they drank during the last 12 months — regardless of added sweeteners, creams or flavors. Cup size was not standardized.
In the new study, Dr. Barbagallo and his colleagues analyzed those cognitive assessments and examined whether drinking coffee might avoid the cognitive decline that is a known hazard of AF.
Because Alzheimer’s disease and AF are associated with systemic inflammation, the researchers also analyzed markers of inflammation.
Overall, higher cognitive test scores were associated with higher coffee consumption. Specifically, scores for processing speed, visuomotor coordination and attention improved significantly by 11% among coffee consumers compared to non-consumers.
Cognitive age was calculated to be 6.7 years younger among those who drank the most coffee compared to those who drank the least.
Inflammatory markers were more than 20% lower in participants drinking five cups daily than in participants drinking less than one cup daily.
“There was a very clear and consistent ‘dose-response’ association between drinking more coffee and doing better on several different sophisticated cognitive tests,” said University of Zürich’s Professor Jürg Beer.
“Inflammatory markers decreased with higher coffee consumption, an association that remained after considering variables such as age, sex, body mass index, smoking status, physical activity and a history of stroke.”
“Previous studies suggest that the protective effects of regular coffee consumption against cognitive decline in the elderly may be attributed to caffeine and other active ingredients including magnesium and vitamin B3 (Niacin); or, that it may be due to coffee’s role in reducing chemicals that cause inflammation.”
The findings were published in the Journal of the American Heart Association.
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Massimo Barbagallo et al. Coffee Consumption Correlates With Better Cognitive Performance in Patients With a High Incidence for Stroke. Journal of the American Heart Association, published online December 14, 2024; doi: 10.1161/JAHA.124.034365
