Impact of prolonged hospitalization and inadequate anticoagulation on cognitive decline in older patients with atrial fibrillation.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος:	Impact of prolonged hospitalization and inadequate anticoagulation on cognitive decline in older patients with atrial fibrillation.
Μεταγλωττισμένος Τίτλος:	Impacto de la hospitalización prolongada y de la anticoagulación inadecuada en el deterioro cognitivo del paciente mayor con fibrilación auricular.
Συγγραφείς:	Burgos Bencosme N; Área de gestión clínica de Geriatría, Hospital Monte Naranco, Oviedo, España; Área de gestión clínica de Geriatría, Hospital Universitario Central de Asturias, Oviedo, España; Área de gestión clínica de Neurología, Hospital Universitario Central de Asturias, Oviedo, España. Electronic address: n.burgosbencosme@gmail.com., Herrera Parra JE; Área de gestión clínica de Geriatría, Hospital Monte Naranco, Oviedo, España; Área de gestión clínica de Geriatría, Hospital Universitario Central de Asturias, Oviedo, España., Antuña Montes L; Área de gestión clínica de Geriatría, Hospital Monte Naranco, Oviedo, España; Área de gestión clínica de Geriatría, Hospital Universitario Central de Asturias, Oviedo, España., Rodríguez Santiago SE; Área de gestión clínica de Geriatría, Hospital Monte Naranco, Oviedo, España; Área de gestión clínica de Geriatría, Hospital Universitario Central de Asturias, Oviedo, España., González Delgado M; Área de gestión clínica de Neurología, Hospital Universitario Central de Asturias, Oviedo, España; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, España., Gutiérrez Rodríguez J; Área de gestión clínica de Geriatría, Hospital Monte Naranco, Oviedo, España; Área de gestión clínica de Geriatría, Hospital Universitario Central de Asturias, Oviedo, España; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, España.
Πηγή:	Medicina clinica [Med Clin (Barc)] 2026 Aug; Vol. 166 (8), pp. 107515. Date of Electronic Publication: 2026 Jun 28.
Τύπος έκδοσης:	Journal Article; Observational Study
Γλώσσα:	English; Spanish; Castilian
Στοιχεία περιοδικού:	Publisher: Elsevier España Country of Publication: Spain NLM ID: 0376377 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1578-8989 (Electronic) Linking ISSN: 00257753 NLM ISO Abbreviation: Med Clin (Barc) Subsets: MEDLINE
Imprint Name(s):	Publication: <2009- > : Madrid : Elsevier España Original Publication: Barcelona : Ediciones Doyma, S.A.
Ιατρικοί όροι (MeSH):	Atrial Fibrillation/drug therapy , Atrial Fibrillation/complications , Anticoagulants/therapeutic use , Anticoagulants/administration & dosage , Length of Stay/statistics & numerical data , Cognitive Dysfunction/etiology , Cognitive Dysfunction*/epidemiology, Humans ; Female ; Aged, 80 and over ; Male ; Retrospective Studies ; Risk Factors ; Prospective Studies ; Hospitalization
Περίληψη:	Background and Objective: Atrial fibrillation (AF) and prolonged hospitalization are known risk factors for cognitive decline (CD). However, whether anticoagulation quality during admission is associated with differences in CD risk among geriatric patients remains unknown. The objective is to evaluate the association between anticoagulation profile and the frequency of new-onset CD in older hospitalized patients with AF. Material and Methods: Ambispective observational study including 254 patients aged ≥80 years with AF admitted to an acute geriatric unit (2019-2022). The retrospective phase included the collection of baseline clinical variables from electronic health records; the prospective phase comprised scheduled cognitive follow-up at 6 and 12 months after discharge. Hospital length of stay and anticoagulation quality (Adequate, Inadequate/Underdosing, or No treatment) were analyzed. The primary outcome was the cumulative frequency of new-onset CD at 12 months. Results: The cumulative frequency of CD was 18.9%. Patients with adequate anticoagulation had a lower frequency (13.5%; 95%CI 8.3-18.7) compared with those with inadequate dosing (27.9%; 95%CI 18.2-37.6) and no treatment (33.9%; 95%CI 21.4-46.4). In multivariable analysis, inadequate anticoagulation (HR 1.78; 95%CI 1.15-2.85) and absence of treatment (HR 2.25; 95%CI 1.35-3.65) were independently associated with CD, as was very prolonged hospital stay (HR 2.41; 95%CI 1.45-3.95). Adequate anticoagulation was associated with greater deterioration-free survival even among patients with prolonged stays. Conclusions: Prolonged hospitalization and inadequate or absent anticoagulation were associated with a higher frequency of new-onset cognitive decline. Optimizing anticoagulation represents a recommended and timely strategy associated with cognitive preservation in older hospitalized patients. (Copyright © 2026 Elsevier España, S.L.U. All rights reserved.)
Contributed Indexing:	Keywords: Anciano frágil; Anticoagulación oral; Atrial fibrillation; Cognitive dysfunction; Deterioro cognitivo; Fibrilación auricular; Frail elderly; Hospitalización prolongada; Length of stay; Oral anticoagulation
Substance Nomenclature:	0 (Anticoagulants)
Entry Date(s):	Date Created: 20260628 Date Completed: 20260723 Latest Revision: 20260723
Update Code:	20260724
DOI:	10.1016/j.medcli.2026.107515
PMID:	42365807
Βάση Δεδομένων:	MEDLINE

Περιγραφή
ISSN:	1578-8989
DOI:	10.1016/j.medcli.2026.107515