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Atrial fibrillation is a common heart condition for which a blood-thinning drug warfarin is commonly prescribed. Recent research has unearthed a potential side effect of warfarin- increase in the risk of dementia.

Warfarin is used for the purpose of preventing the clotting of blood and has proved to be a lifesaving drug for a variety of conditions, atrial fibrillation being one of them. Atrial fibrillation (AF) is a type of arrhythmia in which the heart beat becomes quite irregular and abnormally fast. 

The signs and symptoms of atrial fibrillation include difficulty in breathing, palpitations, dizziness and fatigue etc. The condition is associated with the risk of blood clot formation within heart which can result in stroke. Warfarin, by inhibiting the formation of blood clots, dramatically reduces the risk of stroke, saving the life of the patients. 

A recently held study has pointed out that over time, the blood thinning property of warfarin can increase the likelihood of bleeding within the brain and can lead to dementia. 

Warfarin May Cause Dementia

The study was carried out by Dr. T. Jared Bunch and fellow researchers at Intermountain Medical Center Heart Institute in Salt Lake City, UT. They looked at the data of 10,000 patients taking warfarin in order to look into the possible relationship between warfarin use, dementia and atrial fibrillation. The research findings were later presented at the Heart Rhythm Society's 37th Annual Scientific Session. 
Majority of the patients taking warfarin were taking it for the treatment of atrial fibrillation. However, some of them were using warfarin for other blood clot related conditions like thromboembolism and valvular heart diseases. None of the study subjects had any previous history of dementia. 

The subjects were followed up for 7 years. The data obtained after 7 years interval was quite disturbing, revealing that 5.8 percent of the people taking warfarin for atrial fibrillation had dementia as compared to a mere 1.6 percent people taking warfarin for other conditions. 
People using warfarin for AF for long term were found to be more likely to develop vascular dementia and eventually, Alzheimer’s disease, as compared to people taking it for non-AF causes. 

Warfarin and the Threats Associated With It

The administration of warfarin is quite tricky. One must weigh the potential benefits and risks associated with it before prescribing it. The response to warfarin varies between different patients. Besides, finding the precise dose can turn out to be a time consuming process since the onset of action for warfarin occurs late. 

Previously it was thought that the risk of dementia in patients on long term warfarin therapy was dose dependent.  Now it is known that the risk of dementia increases irrespective of the dose of warfarin. This study is the first of its kind to show the risk of cognitive decline associated with long term anticoagulation with warfarin. 

The Future Prospects

According to Dr. Bunch, the lead researcher, the results are going to have a significant impact on warfarin administration in future. He believes that it may lead to formulation of guidelines that will allow prescription of warfarin only when no other suitable alternative exists. 
He went on to advise that the use of other anticoagulant drugs like Aspirin should also be avoided. When it becomes altogether impossible to avoid the use of blood thinning drugs, newer and safer drugs should be used instead of warfarin. 

Since warfarin is a widely used drug, the findings of this study are likely to pave way for further research into the safety of this drug. 

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