NOACs slow cognitive decline in Alzheimer's

A nationwide Swedish observational study from Karolinska Institute, published in the European Heart Journal, found that patients with both atrial fibrillation and Alzheimer's disease who were treated with newer oral anticoagulants (NOACs) experienced a significantly slower rate of cognitive decline compared with those receiving warfarin or no anticoagulant treatment. The study analyzed data from the SveDem register, including 7,308 matched patients, and tracked cognitive function using the Mini-Mental State Examination (MMSE). The difference was just over 0.2 MMSE points per year, modest on an individual basis but potentially meaningful over time. NOAC treatment was also associated with lower risks of death, stroke, blood clots, and fractures, while warfarin was linked to a higher risk of major bleeding. The researchers, led by Greta Duréel and Nanbo Zhu, caution that the observational design cannot establish causality and that randomized trials are needed. The study was funded by the Sweden — Swedish Research Council, the Swedish Brain Foundation, CIMED, and Karolinska Institute funds.