1. In this cohort of individuals with atrial fibrillation (AF), coffee consumption was associated with a higher performance on cognitive tests in a dose-dependent manner, and a decreased presence of inflammatory markers.
Evidence Rating Level: 1 (Excellent)
Atrial fibrillation (AF) is a common heart condition, associated with mild cognitive impairment, and increasing the risk of thromboembolic stroke. Prior epidemiologic studies have suggested a protective effect of regular coffee consumption against cognitive decline. The goal of this observational prospective cohort study was to investigate the association between regular coffee consumption and cognitive impairment in patients with AF. Individuals could be included in the study if they were 65 years of age or older, with a history of AF. Several cognitive assessments were performed including the Montreal Cognitive Assessment (MoCA) questionnaire, the Trail-Making Test (TMT), the Digit Symbol Substitution Test (DSST), and the cognitive construct (CoCo) score. A total of 2413 patients were included (mean age, 73 years), with almost half of the participants drinking 2-3 cups of coffee/day (n=1165, 48.3%). Compared to the control group (-0.24 [95% CI, -0.27 to -0.16), all coffee consumer groups had greater CoCo scores, with the greatest scores achieved by the group with the highest consumption (-0 .10 [95% CI, -0.10 to 0.04; P=0.048]). The results were similar for the MoCA scores, with the lowest scores amongst the control group (24.58 [95% CI, 24.58-25.32]) and the highest scores in the group with the highest coffee intake (25.25 [95% CI, 24.98-26.85; P=0.163]). The presence of inflammatory markers also decreased with increasing coffee intake. Inflammatory markers showed a decrease with increased coffee consumption: hs-CRP (high-sensitivity C-reaction protein) levels were reduced by a factor of 0.78 (95% CI, 0.54-1.13, P=0.188) when consuming ≥5 cups/day compared to <1 cup/day, while IL-6 (interleukin-6) levels decreased by a factor of 0.73 (95% CI, 0.57-0.95, P=0.017). Overall, this prospective cohort study found that in individuals with AF, consuming more coffee was associated with better performance on cognitive tests. Further research is needed to best understand the optimal coffee consumption dose.
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