Association Between Motor and Cognitive Performances in Elderly With Atrial Fibrillation: Strat-AF Study

Emilia Salvadori, Francesco Galmozzi, Francesca Uda, Carmen Barbato, Eleonora Camilleri, Francesca Cesari, Stefano Chiti, Stefano Diciotti, Samira Donnini, Benedetta Formelli, Silvia Galora, Betti Giusti, Anna Maria Gori, Chiara Marzi, Anna Melone, Damiano Mistri, Francesca Pescini, Giovanni Pracucci, Valentina Rinnoci, Cristina SartiEnrico Fainardi, Rossella Marcucci, Anna Poggesi

Research output: Contribution to journalArticlepeer-review


Background/Objective: Growing evidence suggests a close relationship between motor and cognitive abilities, but possible common underlying mechanisms are not well-established. Atrial fibrillation (AF) is associated with reduced physical performance and increased risk of cognitive decline. The study aimed to assess in a cohort of elderly AF patients: (1) the association between motor and cognitive performances, and (2) the influence and potential mediating role of cerebral lesions burden. Design: Strat-AF is a prospective, observational study investigating biological markers for cerebral bleeding risk stratification in AF patients on oral anticoagulants. Baseline cross-sectional data are presented here. Setting: Thrombosis outpatient clinic (Careggi University Hospital). Participants: One-hundred and seventy patients (mean age 77.7 ± 6.8; females 35%). Measurements: Baseline protocol included: neuropsychological battery, motor assessment [Short Physical Performance Battery (SPPB), and walking speed], and brain magnetic resonance imaging (MRI) used for the visual assessment of white matter hyperintensities, lacunar and non-lacunar infarcts, cerebral microbleeds, and global cortical and medial temporal atrophies. Results: Mean Montreal Cognitive Assessment (MoCA) total score was 21.9 ± 3.9, SPPB total score 9.5 ± 2.2, and walking speed 0.9 ± 0.2. In univariate analyses, both SPPB and walking speed were significantly associated with MoCA (r = 0.359, r = 0.372, respectively), visual search (r = 0.361, r = 0.322), Stroop (r = −0.272, r = −0.263), short story (r = 0.263, r = 0.310), and semantic fluency (r = 0.311, r = 0.360). In multivariate models adjusted for demographics, heart failure, physical activity, and either stroke history (Model 1) or neuroimaging markers (Model 2), both SPPB and walking speed were confirmed significantly associated with MoCA (Model 1: β = 0.256, β = 0.236; Model 2: β = 0.276, β = 0.272, respectively), visual search (Model 1: β = 0.350, β = 0.313; Model 2: β = 0.344, β = 0.307), semantic fluency (Model 1: β = 0.223, β = 0.261), and short story (Model 2: β = 0.245, β = 0.273). Conclusions: In our cohort of elderly AF patients, a direct association between motor and cognitive functions consistently recurred using different evaluation of the performances, without an evident mediating role of cerebral lesions burden.

Original languageEnglish
Article number571978
JournalFrontiers in Neurology
Publication statusPublished - Nov 13 2020


  • atrial fibrillation
  • cognition
  • elderly
  • gait speed
  • motor performance

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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