Italian Research Finds Atrial Fibrillation Patients on Anticoagulants Still Face Cognitive Decline

The Strat‑AF study, conducted by the CNR Institute of Neurosciences together with Careggi University Hospital and the University of Florence, is the first worldwide analysis quantifying cognitive decline among seniors with atrial fibrillation who are already receiving oral anticoagulant therapy. Researchers followed 140 participants over the age of 65 for about two years, performing regular neuro‑psychological assessments. Thirty patients (an estimated incidence of 14 new cases per 100 persons per year) showed measurable cognitive deterioration, roughly double the rate observed in the general elderly population.

The investigation identified vascular comorbidities—coronary artery disease, prior stroke, and diabetes—as major risk enhancers, while higher education levels and better baseline cognitive performance acted as protective factors. The findings suggest that anticoagulation alone does not fully safeguard brain health in this group and that systematic vascular risk management and routine cognitive screening should accompany standard stroke‑prevention treatment. Atrial fibrillation affects about 59 million people globally, underscoring the broader relevance of these results.