For people with both Alzheimer's disease and atrial fibrillation, the type of blood thinner they take might affect how quickly their memory and thinking skills decline. New research suggests that newer blood thinners, called NOACs, could slow this decline.
NOACs, also known as direct oral anticoagulants (DOACs), are medications that prevent strokes and blood clots. They are often used for people with atrial fibrillation, a common irregular heartbeat. Examples include apixaban (Eliquis) and rivaroxaban (Xarelto).
How NOACs May Help Cognition
A study from Karolinska Institutet found that patients taking NOACs experienced a slower rate of cognitive decline. This was compared to those taking warfarin, an older blood thinner, or no anticoagulant at all. The findings were published in the European Heart Journal.
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Start Your News DetoxAtrial fibrillation is common in older adults, including many with Alzheimer's. Blood thinners are often prescribed to lower the risk of dangerous blood clots. Previous studies hinted that these medications might reduce the chance of developing dementia. However, less was known about their effect on cognition once Alzheimer's had already started.
Maria Eriksdotter, a professor at Karolinska Institutet who led the study, explained why this might be. She noted that these treatments could help by improving blood flow and reducing small damage in the brain.
Tracking Over 7,000 Patients
Researchers looked at records from 7,308 people with both atrial fibrillation and Alzheimer's disease. These records came from the Swedish Register for Cognitive Disorders/Dementia (SveDem).
The participants were divided into three groups: those taking NOACs, those taking warfarin, and those not taking any anticoagulant. The researchers tracked changes in their cognitive abilities using a standard test called the Mini-Mental State Examination (MMSE).
The results showed that people taking NOACs had a noticeably slower decline in cognitive function. This difference was about 0.2 MMSE points each year.
Nanbo Zhu, a researcher on the study, said that while the difference is small year-to-year for one person, it could have a bigger impact over time. This suggests NOACs might be important for cognition in these patients.
Other Health Benefits and Limitations
The study also found other health differences. Compared to those not on anticoagulants, people taking NOACs had lower risks of death, stroke, blood clots, and fractures. Warfarin also lowered risks of death, stroke, and blood clots, but it was linked to a higher risk of major bleeding.
It's important to remember that this was an observational study. This means it can't definitively prove that NOACs caused the slower cognitive decline or other health benefits. The researchers also couldn't fully account for all factors that might influence medication choices and health outcomes. Some participants might have also changed their medications during the study.
Deep Dive & References: Oral anticoagulants, cognition, and clinical outcomes in atrial fibrillation and Alzheimer’s disease: a Swedish nationwide study - European Heart Journal, 2026
