ABSTRACT

Background:
Atrial fibrillation is an independent risk factor for the development of cognitive impairments. Regular coffee consumption has shown cognitive benefits in healthy individuals. Whether regular consumption reduces cognitive decline in vulnerable patients is controversial. We investigated the association in elderly people with atrial fibrillation.

Methods and results:
Daily coffee consumption was assessed using a structured nutrition questionnaire, and cognitive function was evaluated by a detailed neurocognitive-test-battery, including the Montreal Cognitive Assessment, Trail-Making Test, semantic fluency, and Digit-Symbol-Substitution Test. The cognitive construct score combines all neurocognitive tests mentioned and provides an overall cognitive performance indicator. Hs-CRP (high-sensitivity C-reactive protein) and IL-6 (interleukin-6) were measured to explore an association with inflammation. Results were estimated using linear mixed-effects-models with detailed adjustments for confounders. The <1 cup/day consumers (reference group) reached a cognitive construct score of -0.24 (95% CI, -0.27 to -0.16), and the group with the highest consumption (>5 cups/day) was at -0.10 (95% CI, -0.10 to 0.04; p=0.048). Montreal Cognitive Assessment score in the reference group was 24.58 (95% CI, 24.58-25.32); the group with the highest intake achieved 25.25 (95% CI, 24.98-26.85; p=0.163). Inflammatory markers decreased with higher coffee consumption (hs-CRP with 5 compared with <1 cup/day by factor 0.78 [95% CI, 0.54-1.13], p= 0.188, IL-6 significantly by factor 0.73 [95% CI, 0.57-0.95], p=0.017).

Conclusions:
Coffee consumption in patients with atrial fibrillation may be associated with improved cognitive performance and reduced inflammatory markers. Further research is needed to confirm these findings and to consider implementation in dietary counseling for atrial fibrillation management.

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