Coffee Consumption May Protect Against Cognitive Decline in People with Atrial Fibrillation

Drinking multiple cups of coffee daily may help prevent cognitive decline in individuals with atrial fibrillation (AFib), according to research published on December 14, 2024, in the Journal of the American Heart Association, a peer-reviewed, open-access publication.

“Despite the myths surrounding coffee, our study found no evidence to discourage patients with AFib from enjoying it. In fact, it might even offer some benefits,” said Jürg H. Beer, M.D., senior author of the study and professor of medicine and hematology at the University of Zürich, Switzerland.

Atrial Fibrillation and Coffee: Current Understanding

Atrial fibrillation, the most common heart rhythm disorder in adults, affects over 5 million people in the U.S., according to the American Heart Association (AHA). The 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation highlights that abstaining from caffeine offers no benefit in preventing heart rhythm disturbances for people with AFib. However, for those who experience AFib symptoms—such as rapid heartbeat, dizziness, and fatigue—triggered by caffeine, reducing coffee intake may alleviate discomfort.

“It’s well-established that regular coffee consumption enhances cognitive performance in healthy individuals,” said Massimo Barbagallo, M.D., lead author and neuro-intensive care resident at the University Hospital Zürich. “Given that AFib increases dementia risk, we explored whether coffee could mitigate this cognitive impairment.”

Study Insights: The Swiss-AF Cohort

The Swiss Atrial Fibrillation Cohort Study (Swiss-AF) monitored 2,400+ individuals diagnosed with AFib from 2014 to 2017. Participants underwent cognitive testing and reported their coffee intake over the past year. Researchers analyzed cognitive performance, systemic inflammation markers, and the potential link between coffee consumption and cognitive health.

Key Findings:

• Cognitive Performance: Higher coffee consumption correlated with better scores in processing speed, visuomotor coordination, and attention, with coffee drinkers performing 11% better on these tests than non-drinkers.
• Cognitive Age: Those consuming the most coffee had a cognitive age approximately 6.7 years younger than those consuming the least.
• Inflammation Markers: Participants drinking five or more cups daily had over 20% lower inflammatory markers than those drinking less than one cup daily.
• No Demographic Differences: Results were consistent regardless of age or sex.

“We observed a clear dose-response relationship: the more coffee consumed, the better the cognitive test results,” Dr. Beer noted. This improvement was associated with reduced inflammation, independent of other variables such as smoking, BMI, physical activity, or stroke history.

Coffee’s Potential Role in Cognitive Health

Previous research suggests coffee’s cognitive benefits may be attributed to its caffeine content and other active compounds, such as magnesium and vitamin B3 (niacin), or its ability to reduce inflammation-inducing chemicals. However, the study authors emphasize that these findings are observational.

“We cannot definitively conclude that coffee prevents long-term cognitive decline in AFib patients,” cautioned José A. Joglar, M.D., FAHA, chair of the 2023 AFib management guideline. “While coffee doesn’t appear to worsen AFib, starting to drink it solely to prevent cognitive decline isn’t supported by this study.”

Study Limitations and Future Directions

The study’s limitations include its cross-sectional design, which captured coffee consumption and cognitive performance at the same time, making it impossible to establish cause-and-effect relationships. Additionally, participants’ coffee consumption habits may have changed over time, and the results may not be generalizable beyond Switzerland’s predominantly white population, which favors espresso-style coffee.

“To truly assess cognitive decline, a follow-up period of 5-10 years is necessary,” Dr. Barbagallo explained. “Nevertheless, the long-term coffee habits of participants likely influenced the observed results.”

Study Details:

• Participants: 2,413 individuals (average age 73; 27% women) with AFib.
• Data Collection: Cognitive tests assessed verbal skills, memory, executive functioning, and more. Coffee consumption was categorized into five levels, from less than one cup daily to more than five cups.
• Additional Measures: Depression was evaluated using the Geriatric Depression Scale to account for its potential impact on cognitive performance.

This research adds to the growing body of evidence suggesting that coffee, when consumed in moderation, may have a protective effect on cognitive health—offering reassurance to AFib patients who enjoy their daily cup of coffee.