The impact of anemia and iron deficiency on cognitive function in young and middle-aged patients with non-valvular atrial fibrillation
L. V. Glukhacheva,
O. D. Ostroumova,
A. A. Tyazhelnikov,
A. I. Kochetkov,
T. M. Ostroumova,
G. F. Piksina,
M. V. Lopukhina,
A. Ya. Starokozheva,
S. S. Telkova https://doi.org/10.21518/ms2026-209
Abstract
Introduction. Atrial fibrillation (AF) is an independent risk factor for cognitive decline (CD). However, the role of iron deficiency (ID) and anemia as modifiable factors exacerbating cognitive impairment in this issue remains understudied.
Aim. To assess the impact of anemia/ID on the condition of cognitive functions young and middle age patients with AF. Materials and methods. This cross-sectional study included 45 patients with AF (median age 53.2 [50.4; 57.2] years), divided into two groups: with anemia and/or ID (n = 23) and without (n = 22). Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), Trail Making Test (Parts A & B), Verbal Fluency Test, Word-List Recall, Stroop Test, Digit Span Test, and Digit Symbol Substitution Test (DSST). Anxiety and depression levels were evaluated using the Beck Anxiety Inventory (BAI) and Hamilton Depression Rating Scale (HDRS).
Results. Compared to patients without anemia/ID, patients with AF and anemia/ID demonstrated significantly lower total scores on the MoCA (26 [25; 27] vs 28 [27; 28.5] points, p < 0.001) and MMSE (26 [25; 26] vs 28 [28; 29] points, p < 0.001). They also showed reduced performance in immediate word recall (4 [4; 5] vs 5 [5; 5.3] words, p = 0.032), delayed recall (3 [3; 3.3] vs 4 [4; 5] words, p < 0.001), and the letter fluency test (13 [12.8; 14] vs 14 [13; 15] words, p = 0.013). Psychomotor speed was slower on the DSST (46 [41; 50] vs 55 [44.8; 65] points, p = 0.011), attention was worse on the Digit Span Test (4 [4; 4.3] vs 5 [4.8; 5.3] points, p = 0.005), and execution time was longer for Trail Making Test Part A (61.5 [57.8; 63.8] vs 50 [45; 57.3] s, p < 0.001) and Part B (79.5 [74; 92] vs 69 [64; 77] s, p < 0.001).
Conclusions. Anemia/ID in young and middle-aged patients with AF is associated with multiple cognitive deficits, which justifies the need for screening of iron metabolism and hemoglobin levels in this patient population.
About the Authors
L. V. Glukhacheva
Russian Medical Academy of Continuous Professional Education;
Municipal Clinical Hospital No. 15 named after O.M. Filatov
Russian Federation
Russian Federation
Luibov V. Glukhacheva, Candidate for a Degree, Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi, Russian Medical Academy of Continuous Professional Education; Cardiologist, Cardiology Department, Municipal Clinical Hospital No. 15 named after O.M. Filatov
2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993;
23, Veshnyakovskaya St., Moscow, 111539
O. D. Ostroumova
Russian Medical Academy of Continuous Professional Education;
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Olga D. Ostroumova, Dr. Sci. (Med.), Professor, Head of the Department of Therapy and Polymorbid Pathology named after Academician M. S. Vovsi, Russian Medical Academy of Continuous Professional Education; Professor of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases of the Sechenov First Moscow State Medical University (Sechenov University)
2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993;
8, Bldg. 2, Trubetskaya St., Moscow, 119048
A. A. Tyazhelnikov
Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
Andrey A. Tyazhelnikov, Dr. Sci. (Med.), Professor, Professor of the Department of Public Health and Healthcare named after Yu.P. Lisitsyn
1, Ostrovityanov St., Moscow, 117997
A. I. Kochetkov
Russian Medical Academy of Continuous Professional Education
Russian Federation
Russian Federation
Alexey I. Kochetkov, Cand. Sci. (Med.), Associate Professor of the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi
2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993
T. M. Ostroumova
Russian Medical Academy of Continuous Professional Education;
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Tatiana M. Ostroumova, Cand. Sci. (Med.), Assistant of the Department of Nervous Diseases and Neurosurgery, Sechenov First Moscow State Medical University (Sechenov University); Associate Professor of the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi, Russian Medical Academy of Continuous Professional Education
8, Bldg. 2, Trubetskaya St., Moscow, 119048;
2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993
G. F. Piksina
Municipal Clinical Hospital No. 15 named after O.M. Filatov
Russian Federation
Russian Federation
Galina F. Piksina, Cand. Sci. (Med.), Cardiologist, Acting Deputy Chief Physician for Emergency Care
23, Veshnyakovskaya St., Moscow, 111539
M. V. Lopukhina
Municipal Clinical Hospital No. 15 named after O.M. Filatov
Russian Federation
Russian Federation
Mariya V. Lopukhina, Cand. Sci. (Med.), Functional Diagnostics Physician, Head of the Diagnostic Department
23, Veshnyakovskaya St., Moscow, 111539
A. Ya. Starokozheva
Russian Medical Academy of Continuous Professional Education;
Central Clinical Hospital “RZD-Medicine”
Russian Federation
Russian Federation
Anastasiya Ya. Starokozheva, Cand. Sci. (Med.), Cardiologist, Assistant of the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi, Russian Medical Academy of Continuous Professional Education; Head of the Department of Cardiology, Central Clinical Hospital “RZD-Medicine”
2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993;
2, Budayskaya St., Moscow, 129128
S. S. Telkova
Russian Medical Academy of Continuous Professional Education
Russian Federation
Russian Federation
Svetlana S. Telkova, Postgraduate Student, Senior Assistant of the Academician M.S. Vovsi of Department of Therapy and Polymorbid Pathology
2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993
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Glukhacheva LV, Ostroumova OD, Tyazhelnikov AA, Kochetkov AI, Ostroumova TM, Piksina GF, Lopukhina MV, Starokozheva AY, Telkova SS. The impact of anemia and iron deficiency on cognitive function in young and middle-aged patients with non-valvular atrial fibrillation. Meditsinskiy sovet = Medical Council. 2026;(7):187-194. (In Russ.) https://doi.org/10.21518/ms2026-209
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