emcardioНеотложная кардиология и кардиоваскулярные рискиEmergency Cardiology and Cardiovascular Risks journal2616-633XБелорусский государственный медицинский университет10.51922/2616-633X.2026.10.1.2716emcardio-339Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESКогнитивные нарушения и фибрилляция предсердий: эпидемиология, патофизиологические механизмы, факторы риска и перспективыCognitive Impairment and Atrial Fibrillation: Epidemiology, Pathophysiological Mechanisms, Risk Factors, and Future PerspectivesТименоваС. В.TsimenavaS. V.

Гродно

Grodno

tsimenava@gmail.comСнежицкийВ. А.SnezhitskiyV. A.

Гродно

Grodno

КулешС. Д.KuleshS. D.

Гродно

Grodno

ЛебецкаяА. И.LiabetskayaA. I.

Гродно

Grodno

БросьН. А.BrosN. A.

Гродно

Grodno

УО «Гродненский государственный медицинский университет»; УЗ «Гродненская университетская клиника»БеларусьGrodno State Medical University; Grodno University HospitalBelarusУО «Гродненский государственный медицинский университет»БеларусьGrodno State Medical UniversityBelarusУЗ «Гродненская университетская клиника»БеларусьGrodno University HospitalBelarus20262107202610127162721Copyright © Тименова С.В., Снежицкий В.А., Кулеш С.Д., Лебецкая А.И., Брось Н.А., 20262026Тименова С.В., Снежицкий В.А., Кулеш С.Д., Лебецкая А.И., Брось Н.А.Tsimenava S.V., Snezhitskiy V.A., Kulesh S.D., Liabetskaya A.I., Bros N.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://emcardio.bsmu.by/jour/article/view/339

Фибрилляция предсердий и деменция являются наиболее распространенными неинфекционными заболеваниями стареющего населения, представляющими значительное бремя для системы здравоохранения. Долгое время их сочетание объясняли общими факторами риска. Однако, накапливающиеся данные проспективных исследований свидетельствуют о том, что фибрилляция предсердий сама по себе независимо связана с повышенным риском развития когнитивных нарушений и деменции, даже у пациентов без инсульта в анамнезе. В данном обзоре анализируются методологические трудности изучения данной проблемы, обобщаются современные данные о патогенетических механизмах, связывающих фибрилляцию предсердий и снижение когнитивных функций. В обзоре приведены такие механизмы развития когнитивных нарушений, как церебральная гипоперфузия, «немые» микроэмболии, церебральная микроангиопатия, хроническое системное воспаление. А также приведены данные о влиянии различных стратегий лечения фибрилляции предсердий (антикоагулянтная терапия, контроль ритма) на когнитивные функции.

Atrial fibrillation (AF) and dementia represent the most prevalent non-communicable diseases affecting the aging population posing a substantial burden on healthcare systems. For a long time, this comorbidity was attributed solely to shared risk factors. However, accumulating evidence from prospective studies indicates that AF per se is independently associated with an increased risk of cognitive impairment and dementia, even in patients without a history of stroke. This review analyzes the methodological challenges inherent in studying this relationship and synthesizes current evidence on the pathophysiological mechanisms linking AF to cognitive decline. The following pathways are examined: cerebral hypoperfusion, silent microembolization, cerebral microangiopathy, and chronic systemic inflammation. Additionally, data on the effects of various AF management strategies (anticoagulant therapy, rhythm control) on cognitive function are presented.

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The authors declare that there are no conflicts of interest present.