When Health Conditions Masquerade as Cognitive Decline

When Poston went to his spine doctor for a procedure he had received annually for the past 15 years, radiofrequency ablation of the spine specialist told him the procedure could not be performed because Poston appeared to be in AFib (atrial fibrillation), a common heart condition. Poston had high blood pressure but had never heard of AFib and felt no symptoms, but because AFib carries a risk of blood clots and stroke, his doctor advised immediate transport to the emergency room. AFib is a disorder of heart rhythm, not blood pressure, and a person may have normal blood pressure while experiencing a dangerously fast or irregular heart rate.

Poston was taken to the emergency room (ER) at AdventHealth, confused and concerned, as he felt fine and had never faced such an issue in his 79 years. Upon arrival, at the hospital, AFib was confirmed, and he spent two days in the hospital on a medication drip to bring his heart rate down to a safe range. A normal resting heart rate is generally 60–100 beats per minute (bpm), with 65–85 most common. Poston’s heart rate, however, was approximately 150 bpm and at one point spiked to 180 bpm, which had alarmed his spine doctor.

Once stabilized, Poston underwent cardioversion, a controlled electrical reset of the heart rhythm performed under sedation. The procedure was successful. To reduce the risk of recurrence and stroke, he was prescribed a blood thinner along with a compatible blood pressure medication.

Although the diagnosis was unexpected, Poston learned that AFib, when effectively managed, often allows for a life expectancy similar to others without AFib of the same age. It is not uncommon for people to live 20, 30, or even 40+ years with AFib under appropriate medical care.

However, AFib is more than just a medical diagnosis, it is a condition that should be shared with family members and all healthcare providers, including doctors, dentists, and eye doctors. In AFib, the heart pumps inefficiently and irregularly, which can lead to mental fatigue, slower processing speed, and foggy thinking. Individuals may take longer to respond, lose their train of thought, or seem less sharp than before. To family members unfamiliar with AFib, these changes can resemble cognitive decline or the onset of dementia or Alzheimer’s disease.

Unlike Alzheimer’s, however, AFib-related cognitive changes often fluctuate and may improve with proper treatment, whereas Alzheimer’s disease progresses steadily and irreversibly.

It is equally important to inform all healthcare providers of an AFib diagnosis, not as a formality, but because it directly affects medical decisions and helps prevent harm. Dentists may need to adjust techniques to avoid triggering bleeding or heart rhythm issues, and certain eye drops prescribed by ophthalmologists can affect heart rate. Clear communication allows providers to tailor care safely and effectively.

“Cognitive change should never be presumed irreversible without first excluding reversible medical causes.”

At Jackson Law, P.A., whose practice focuses on wills, trusts, probate, and guardianship, we frequently encounter families who misunderstand these changes simply because they are unaware of a loved one’s AFib. Too often, parents or grandparents are mistakenly believed to be developing dementia when, in fact, they are experiencing treatable, AFib-related cognitive effects. With awareness and proper management, these issues can often be addressed, unlike Alzheimer’s disease, which cannot.