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Atrial fibrillation (AF), a well-recognized risk factor for dementia,1 likely increases risk through a higher prevalence of vascular pathology.2 AF does not cause cerebral degenerative changes per se. It appears to lower the threshold for the clinical diagnosis of degenerative and mixed dementias2 probably mediated by an increased burden of symptomatic and asymptomatic cerebrovascular pathology coexisting with degenerative changes.2 As such, oral anticoagulants (OACs) have been historically regarded as potentially beneficial for preventing or delaying dementia in patients with AF.
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