AF and dementia
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- Опубликовано: 10 июл 2024
- Today’s video is on the subject of AF and dementia
The first thing i want to say is that unfortunately the practice of modern day medicine is largely servile to clinical guidelines. We decide how to treat a patient based on how someone else (i.e whoever wrote the guideline) tells us how to manage the patient. If we stick to the guideline, we feel that we are offering top quality care and we can defend ourself in court. If we don't stick to the guideline then we feel vulnerable to criticism by our own colleagues and also medico-legal lawyers.
Much of the guidelines that are published by august bodies like NICE, are based around an examination of the evidence base to see how beneficial an intervention may be but also how cost effective it may be. If it is not deemed beneficial or cost effective, it is not recommended and unfortunately everyone then believes that it is not worth considering in the patient’s management.
The problem is that guidelines lag several years behind research and therefore when scientists find something important through observation, the first thing they have to do is conduct rigorous experiments to confirm or refute their suspicion, then they have to further confirm this by doing large scale human trials, then they have to publish the data, then if the data are very persuasive a bunch of ‘experts’ get together and decide whether the findings are worthy of changing guidance and then that guidance is published and it can take a few years for that change in guidelines to be adopted as a change in medical practice at grassroots level. The whole process can easily take 10-15 years and therefore patients may continue to be managed in sub-optimal manner for this duration of time even when there is available research to say that things could be done better. As doctors are generally very defensive and not particularly reflective, it is important for patients to be aware of the latest research so that they can advocate for themselves and use any available new research in their decision making process. This is the foundation of patient empowerment. This is why i started this channel. I believe that patients should be equipped with all the information that is out there to allow them to work out the best way they would like their condition to be managed and their doctor’s role is that of the educator and enabler rather that the doctor acting as if they know everything and the patient knows nothing.
Today I wanted to talk about some troubling research in the field of AF.
AF stands for atrial fibrillation. AF is one of the most common heart rhythm disturbances and can affect up to 2% of the population. The big risk of AF is thought to be an increased risk of strokes and therefore when we see patients above the age of 65, or patients who carry co-morbidities we recommend lifelong anticoagulation and as long as the patient is anti-coagulated, we feel that the patient is safe. We never really think beyond the risk of stroke. If the patient is younger than 65 and does not carry comorbidities we don’t anticoagulate them because we believe that the risk of stroke is very low.
However over the past few years there have been several studies which have studied AF patients and discovered patients with AF have a significantly higher prevalence of cognitive impairment and dementia and as we do not have any clinical guidelines as yet, we have to try and work out for ourselves as to why there is this association.
Dr Gupta is by far the most qualified doctor you can find on RUclips when it comes to heart issues... 5 years following! Thank you doc!
Entirely Agree! And listening to him has helped me to calm down immensely!!🙏💜
Thank you for your effort in making these videos. I agree with you 100% that patients need to take responsibility for their own health. I have my own health logbook, keeping track of my weight, blood pressure, sleep quality, etc. over time. Too many people take no responsibility for their health and lay everything on the medical system (I live in the U.S.). The internet is a window into all knowledge, no excuse not to do your own homework, working with your doctor.
I suffer from infrequent AF.
I’ve had two ablation operations. Neither were successful. Just by coincidence my heart went into AF last night about 11pm about 9hrs ago.
As I was watching your video this morning it reverted back to normal rhythm as I was watching you. I’m so glad as I thought I was going to have to go to hospital to have a cardio version. It must be your beautiful calming voice.
Thank you so much for your informative and caring videos. You come across as a extremely good and kind human being.
……jim Australia 🇦🇺
This is one of those channels where even if I don’t finish watching it or it’s not relevant to me I still give it a thumbs up because it’s so important to the public.
Thanks Dr Gupta
I had my aortic valve replaced some 6-7 years ago at St George. There they nipped the other atria to reduce the risk of clotting. Over the last 3-4 years I’ve had quite marked memory loss. I scraped through two follow up Alzheimer’s tests with my GP in the last 18 months.
I have enormous dread with Alzheimer’s, with memory of my mothers decline in her Alzheimer’s Hospice in Cornwall.
Thanks so much for your kind research Dr.
You are like a breath of fresh air doctor. Thank you for explaining so that we can understand what's going on. We are too passive when it comes to our own health. Just accepting everything the doctor says and not questioning or informing ourselves. Thank you for all that you do.
Dr. Gupta, Your information is invaluable. Thank you for speaking about your analysis of medical issues that are not yet mainstream. It is my genuine belief that you have a lot of courage challenging status quote. Many lives are and continue to be helped with your knowledge and generosity in sharing your thoughts! Thank you and may God always bless you richly!
Thank you so much. I have been on Eliquis 5mg twice a day since I had AF in Nov 2019. I know that I may have to be on anticoagulants for the rest of my life. I am glad to hear of this study as obviously, I do not want to have dementia in my later life. I am 67 now. I am also a former nurse.
Don't rely on that pill alone to save you, it is food intake and lifestyle, exercise that staves off brain problems.
I am the same age as you. And my first AF episode was about a year before yours. I take xarelto 20mgs once a day. So far I have not had any problems with it.
What I was wondering is if anybody else in your family has or had AF? I'm wondering if there's a genetic link? Also, I find it weird that I can go many months with no AF symptoms at all. And then I can have AF episodes from out of the blue, back to back for a week or two!😳 WTH!?🤔
It's been a while ( since the middle of summer) since my last AF.
I've never had to go to the hospital again, outside of that first AF event, so that's reassuring, I guess? 😊
@@gloriamaryhaywood2217 My sister and brother have AF and i had palpitations bad few years back but thankfully mine settled down. My brother is 52 and has been told he has AF he is waiting to go on Beta Blocker's and he was told they didn't think it was Heredity! But i think it is and they do
I think msg triggers mine, it's hidden everywhere
@@pam164 One of the main things that beta-blockers do is to slow down your heart rate. During Afib your heart races and is verrry the hell erratic!!.. Just All Over the place! The beta-blockers help with establishing a slower more steady beat. But I quit taking mine several months ago. It left me completely Wiped Out, as it lowered my metabolism along with my heart rate. It was just too slow and sluggish. My regular bmp is around 70-75 without medication. And that is a perfectly normal rate. I feel much better as far as physical energy these days! 🙌 YAY!
BUT I was only on a very low dose to start with. I still take a blood thinner every day and 10mgs of Lisinoprel to manage my blood pressure. Nobody in my family has ever had Afib that I am aware of. But I went thru aggressive chemotherapy a few years ago. Some of the toxic meds that were used to kill the cancer has the potential to cause heart issues later on once all treatment has been stopped. So who knows? But anyways I feel pretty good most days, everything thing considered! Including getting Older!😜
Best wishes to you and your family!😊
Close to my heart ❤️ !! My Dad bless him had Vascular Dementia ! The hospital where he was for a UTI ! Urgh the neglect was shameful and unforgettable ! I took him home ! Clearly they didn’t know a difference from ‘someone ambulating the ward and unconscious! A time in my life I would never wish on any family !!’ 💫
All the best to your father. This great Doc helped me about 4 years ago more than than anyone. 🤟🏽
My husband of 50 years had a heart problems they really didn’t know what kind also had uti he was treated very badly ,he left ama they verbally treat him so bad that was in August ,had another spell with his heart the electrical part stopped and kidneys shut down he passed away January 8 . All hospitals. are over worked ,but being rude and abuse elderly patients is uncalled for 😢
@@marshabowlin1757 so sorry to hear that. What country? They tend to treat the elderly reasonably well in Ireland but the medical system is very bad now.
@@thefuzzfactor2989 USA
@@marshabowlin1757 Why am I NOT surprised that you said the USA?? Our health care system is so dang broken, and it's getting worse and Worse!! So very sorry your poor husband was treated so badly. I know it won't make much difference but you NEED to Report this!! There is NO excuse for rudeness and nasty attitudes towards patients.😡 Especially sick elderly patients who are helpless!!💔
Thank you Dr Gupta for your belief in God, compassion and humanism and ingenious explanation!
Abdollah Gilani, MD, Los Angeles
Thank you for your honesty and integrity. The information is greatly appreciated.
Extremely informative and thought-provoking! Thank you for presenting this!
I am so glad to have had this video flagged up to me. Many thanks for highlighting this which I was totally unaware of. Knowledge is always power!
Thank you Dr. Gupta. I will remember to talk to my cardiologist about this at my next appointment. Keep up the great work.
We are fortunate you exist doctor. we love you. From France.
Dr Gupta, your talk is truly impressive and well thought out. I am impressed. Thank you.
Thank you, Dr. Gupta, my dad had this problem, he has "mini strokes" it showed up on a brain scan. He had no diagnosis of heart disease. He never said he felt like he had a stroke, I had assumed that maybe he stroked after having catarac surgery. He had developed dementia and it was sad because he knew he was declining, he lived to 93
Thank you for taking the time to explain these issues.
Good for you for thinking independently about what is best for your patients!!
Thank u Dr. Sanjay. You are God's gift to humanity! I view your videos from the Caribbean Island of Trinidad. You are an educator and teacher so much love and passion for your patients ❤🙏
This is so interesting, Dr Gupta, as I have been diagnosed with AFib and since taking Magnesium Taurate my brain fog etc has much improved and the AFib.
thank you, Dr Gupta, I love listening to you podcasts
This is one of your scariest videos about AFIB. Thanks for the info to combat the seeming inevitable. If taking Warfarin and Metropolol helps prevent Dementia I'll take the side effects, and continue looking for ways to combat its progression.
I feel that for the past 4 years, my doctors have been simply following guidelines with regards to the treatment of my AF and it has not really helped me, but just held AF at bay with loads of side effects.
I ended up getting short episodes every day until this past week!!
I went for a blood test and one doctor noticed that I was dehydrated. So onto a water drinking regime to get myself better hydrated.
The result …. I have not had a single episode in a week after 4 years of regular episodes every day. My irregular heart beat has also become regular!
Try drinking more water. I am gobsmacked that this has been missed but is the result perhaps of doctors treating the AF and not looking for any causes.
Thank you Dr for all of your wonderful educating videos. Happy New Year to you.
I was diagnosed with lone paroxysmal Afib at 45. I felt strongly at that time that I needed an anticoagulant, because I'd seen the horrendous damage a stroke can do. My Dr reluctantly agreed and I've been on apixaban ever since (10 years). It would appear my gut instinct took me in the right direction.
Thank you Dr Gupta for this information.
Thank you. Clear and informative, and most helpful.
Thank goodness we have you looking out for us. At 74 I am too old to benefit from this discussion but future generations will thank you and so I I on their behalf 💜
Janet! I can give you a few years yet acknowledge the value of this info. I had been beating myself up s until I saw here the AF-induced ssibles. Going on 80, I also have come to accept that none of us is going to get out of this world alive....
Keep up the good work with this excellent channel. I work within the Ambulance service in Manchester and cannot say too much about my thoughts and feelings on the GP management of patients, needless to say I prefer to source my knowledge and information elsewhere !!
Your valuable informations are very much important and useful for more healthy life for the humanity. God bless!
thank you for all this information you give. 4 years following you, and will keep on getting information to be able to work with my Dr. and not just hoping he is making the right decision for me. Do it together. Thank you so much
Thanks god for your generous advice about AFib and dementia,your are great for humanities!
Atrial fibrillation patients on warfarin have increased risk of dementia.
Researchers found that among patients with atrial fibrillation being treated with warfarin, the risk of Alzheimer's disease was increased by 2-fold and the rate of vascular dementia 2.5-fold.May 6, 2016
Thank you for the updated information
Another very well explained piece to camera thank you. And tgank you so much on the heads up on Magnesium, my Wife and have been taking Magnesium Glycinate for just over 12 months and we both have a reduction in our Arthritic pain. And in my case I seem to sleep a whole lot better. Regards
Saving my cardiologist hours of explanations. I have had cognitive decline sometimes after AF. Sometimes my brain adapts and I got over it, and sometimes not. The planning part of the brain is mostly affected. I am on apixaban recently as I turned 60. Previous breast cancer chemo nearly 7 years ago aged my body substancially and things my mother has who is 20 year older are things I am developing now, including Afib.
My goodness, you sound just like us patients having to find the missing piece of the jigsaw puzzle. Thank you ❤️ The missing piece of the jigsaw you just touched on could well be sleep apnoea. In fact COVID prevented us joining with Aintree and the Liverpool Cardio Team to raise awareness of the huge link between AFib and Sleep Apnoea (and of course dementia, cognitive function, diabetes, fibromyalgia etc). Will let you know when we're able to reschedule this event.
Many thanks for this Sanjay, very helpful.
Many sincere thanks to Dr. Gupta . . . This is a great eye opener to us as patients and I admire your sincere efforts in making this video because such a valuable content can’t be found in another place 👏🏻👏🏻🙏🙏🌷🌷😍 , I will definitely take the initiative in managing my own treatment choices based on the points herein 👍
Beautifully put 👏👏👏
Great video! 58 years old with persistent afib & I don't want to develop dementia. Thanks for the information
We can't thank you enough for starting your chanel in the intention of patients empowerment.
GREAT doctor !
Thank you for great information, from Canada.
Thank you Dr for your information.
brilliant as always thanks,
TY Dr. All u xpland makes sense to me as l know l am beginning to see signs of dementia.
I hd AFIB off &on since 7yrs old. At30 was put on meds. Stroke at 68 added xeralto to meds
No correction of afib &mitral regurgitation wd ever b done. Pray no one lives like this❤
Wish u hd been my Dr at 30 yrs old BP alws hi. Pls help others & education. Dr to LISTEN
Thank you. I wish you had over all suggestions on dementia.
Thank you!
My Mum has severe dementia over last 12yrs....When they put a major highway thru her yard, 25m/yards from her home,,,,,20 months of noise/pollution constrution.....that triggered her start of dementia....I'm convinced of that
Many thanks love your information
Very informative Dr. Gupta! I have atrial flutter that has been in sinus since cardioversion in August 2021. Taking Pradaxa 150mg twice/day. I have severe degenerative changes in lumbosacral spine and have had two back surgeries for spinal/foraminal stenosis. Problem with anticoagulants the effect can be affected by RX anti-inflammatory drugs and also supplements that help with inflammation. I may have to pursue Watchman device implantation to get off anticoagulant to be able to treat my arthritis pain. I am sure many here are dealing with similar issues with age.
Thank you Dr .
Thank you.
Ty so much for this information- I had noticed some odd memory issues w my mom prior to her stroke after which her orig cardiologist put her on anti coagulants but advised he didn’t need to see her again- even though she had multiple risk factors (smoking, overweight, likely sleep apnea, likely diabetes- only after her neurologist ordered a 30 day heart monitor did we find out about her afib. She was diagnosed w vascular dementia after the stroke but this information makes me wonder if she was having TIAs or silent infarcts prior to the stroke causing the memory issues. I will def be asking my moms new cardiologist about this. Thank you for giving us the information as many doctors are either too “rushed” or don’t think it’s necessary.
You are lucky to get 15 minutes in an office appointment!
I will need to research and evaluate what impact if any there is with having brain scans upon the brain. This is appreciated information. Thanks Dr.
Thank you doctor so much for the information I to suffer from AF and I have some concerns and I had a talk with my doctor about my memory.
Thank you 🙏
Thanks Doctor. Thank you also for the vid on Magnesium . I tried various supplements of it to lower my B.P. It was 160 over 110. 3 weeks of taking a mix of Magnesium Taureate and MgO today it is 128 over 82. Bless you..
What brand do you use, please?
@@gloriamaryhaywood2217 I found the supermarkets brand( Coles) worked as well as the expensive brands. Do not mix it with blood thinning medicine. Sugar beet provided nitrous oxide which also helps. I am not a medical practitioner, so consult with one first.
Hello from Norway😊🇧🇻
Helpful! I’m new to your channel and am interested in seeing some of these studies. Do you have a page with links somewhere?
Great video.
Thank you for the education on AF/Dementia. When you stated that money was a big culprit in getting these important studies completed, that seems typical in medicine today. I am looking at the Hybrid AF Convergent Therapy. It's new and now reading the trial results. Any input? Thank you.
Thank you
Hi Doc. Watching from Los Angeles CA.
Thankyou very helpful
When you talk about AF is this all forms of AF including paroxysmal? I'm not anticoagulated as I'm low risk no comorbidities and under 60.
Very interesting topic. I do wonder if I have tiny micro clots go to my brain. I have been on xarelto since my afib began and now have a LAA clot! A brain scan I had did show some signs of possible mini TIAS! I have had a few issues with disorientation when driving! I find your chat today to be spot on!
Very informative 🙏🏻
I really appreciate your sincerity and honesty regarding the medical profession . It’s refreshing . I don’t have AF but it’s still interesting to learn about different conditions . I am on anti-coagulants.
very useful , been on rivoroxaban for years , i have arrythmia regularly but at least because of the clotting they put me on a thinner
Thankyou. I have a client ( I am a care worker) who has af and vascular dementia. She is on magnesium which has helped her breathlessness alot. Unfortunately after a fall she has ended up in hospital and not having magnesium now.
Thanks Dr. Gupta for another excellent presentation. I have persistent AF after three ablations and need the best info on how to live with AF and what issues and risks to be aware of.
Oh golly you have had three ablations! I've been a bit scared of having an ablation. Recently I went into persistent a.fib. I live in Ireland and the medical system has become very bad indeed - nit enough doctors on any level. God bless u. Any advice from your own experience appreciated
@@thefuzzfactor2989 I am looking forward to the day my doctor recommends ablation!! Right now he wants to keep using medications to try and control my Afib. But I am sick of medications that don't really work very well, and Sick of Afib!!#UGH. If you are being offered ablation then you are Lucky! Most folks have very good success with totally Stopping Afib in it's tracks with ablation!!😉
ThankU
Thanks doc gupta love from Manipur India
Dr Gupta, you are sounding like my D.O., treating the “whole patient” rather than the disease. Acute medicine saves lives, no question, but treating disease starts before the patient presents, as you mentioned.
My sister and brother have AF. My sister at 60 had op for it and my brother is 52 and just been told he has it and yet Dr said to my brother it wasn't hereditary, but i think it is.
Great videos as ever, would love to see one on Hypertrophic Cardio Myopathy
i have done one - it should be available on the channel
ruclips.net/video/PVncNE8YGKU/видео.html
What do you think about consumer devices like smart watches detecting atrial fibrillation? Is it worth discussing with a doctor if something turns up? Thanks!
Thank you Dr. Sanjay. When these studies are done, is it referring to paroxysmal or full time afib?
This type of research should be funded by governments and universities since theres no profit for big pharma. This is where taxpayer money should flow instead of being wasted on beuracracies and things that have little effect on our lives.
Another question is does AF cause dementia indepentely of the form or the duration of it, meaning if someone has lone paroxysmal AF for two hours every month or so, is the risk same with someone who has permanent AF for many years? obviously not, which is your opinion.
Anticoagulants cause me to be extremely irritable and angry, and give me chronic nausea and stomach pain. I can't be on them for long at all. There are at least two documented case studies on one man and one woman who both developed severe schizophrenic symptoms and who were put through the mill of psychiatric treatment and hospitalisations over a long period of time, only to improve when the anticoagulants were stopped for whatever reason. So they are not benign drugs by any means.
This is why I want to have my own private lab. I am a biochemist and my dream is to have venture capital to help fund these studies to happen. Sigh. :..( Tired of all the suffering.
Dr Gupta please make a video about long covid & the effects it has on the heart! I have been waiting for a long time for a video of you explaining all the heart disturbances covid infection can give you
Great info as usual. Wish you were my heart doctor. I am a 74 yr old woman and have persistent Afib but don’t usually feel it but can monitor it on my Apple Watch. I have been put on xeralto, 20mg, 2.5mg bisoprolol and 0.0625mg of digoxin. I have been on this for about 3 years with a reduction in digoxin to half a pill just last year. I am fair,y active and have Hashimoto thyroditis, psoriasis, and slight lymphedema on my right leg. My pressure, cholesterol and sugar are in range though I could get my sugar down a bit. I am overweight despite eating a balanced diet, with lots of fruit and vegetables. I am also gluten & lactose intolerant. I have tried numerous diets and exercise but have difficulty loosing weight. Help! Very worried about dementia as it is in my family.
I am 55 year's old and have suffered from chronic AF for the past 20 year's. Having had two cardiac ablations which were unsuccessful, I know live with it every day. I believe that my brain function is definitely not as good as it used to be as I quite often forget thing's? It wouldn't supprise me that in later years It will get worse.
hey! i saw a video you did on irregular heart beats and sleep, i have a few questions to ask if thats okay is there an email i can reach you at? id love your opinion! basically my doctor recently have found a 7 - 10 second pause in my heart beat when im sleeping, i currently have a Holter Monitor in my chest but they cant figure out why its happening on a regular every night basis. Let me know if you have any opinions on the matter! thank you!
Hi! Anymore news on vitamin c and AF? Did you ever say what dose was used in those studies???? Thank you.
Interesting... I have AF but have been VERY reluctant to start anticoagulants. Chad Score 1. On the other hand... I also have pulmonary hypertension. Your theory about not enough blood circulating was interesting - If blood flow is restricted from even entering the lungs, the effect on the brain from that. Hmmm....
Doctor I was wondering if I were to show you my EKG report would you be able to tell me if I suffer from it anxiety or having a heart issue because I don't believe I am simply suffering from anxiety
. Oral anticoagulation in patients with AF can lead to new or worsening cerebral microbleeds. In turn, these conditions lead to cognitive decline and increased risk of mild cognitive impairment (MCI) and dementia
what? where is that information from? Should we stop taking anticoagulants?
@@ahish4458 Hello. The article is on ncbi 's site. I'm unable to post the link directly here in the comment section unfortunately. Gets deleted for some reason
I think I’m going to cry. I don’t want to end up drooling in a nursing home… but it looks like that’s going to be my future. :(
5 minute pity party and then start to improve your known risk factors/lifestyle/then get up to speed on the medical literature and studies for your exact condition(s).
Could heart and brain poor glucose metabolism be a cause? I have had both a fib and early onset dementia, both of which have responded to a therapeutic ketogenic diet. If I can keep my GKI around 1, my heart rate stays stable. I've heard that hearts, kidneys, brains, and skeletal muscle can utilize ketones to run.
My dad had it in 2014 / 2024 now my dad currently 64 .. has dementia/alzimer /and life has become living hell for me , my mom ..
Last year my dad did not recognize me and it has broken me
@York Cardiology Can you do a vid on Cholesterol please . And when Statins and other Cholesterol tablets don’t work .
Well, this is bad news for me. I had AF for many years before it was properly treated, which only happened after it was found I had heart failure with a 20% ejection factor. I’m grateful I’m still alive but have already experienced cognitive decline.
Can you please explain us ear lobe creases related to heart diseases ?
Thankyou Dr Gupta, should I go back on baby aspirin? I’m 73 and get a racing hear beat (AF?) once year for a 2-3 seconds.
What about research into AF and the newer anti-coagulant NOAC with regard to cognitive function, has there been any ? (I am a long term CHF patient. (That said, I don't know if Dr Gupta reads viewers' comment/questions.