Incident atrial fibrillation significantly increased the risk of dementia in stroke-free elderly patients (HR 1.52; 95% CI 1.43-1.63), while oral anticoagulant use was associated with reduced risk.
Cohort
Does incident atrial fibrillation increase the risk of incident dementia in stroke-free elderly patients?
262,611 dementia- and stroke-free participants aged ≥60 years in the Korea National Health Insurance Service-Senior cohort
Incident atrial fibrillation (AF)
Propensity score-matched AF-free group
Incident dementiahard clinical
Incident atrial fibrillation is associated with an increased risk of dementia independent of clinical stroke in an elderly population, while oral anticoagulant use is linked with a decreased incidence.
AIMS: Atrial fibrillation (AF) is generally regarded as a risk factor for dementia, though longitudinal studies assessing the association between AF and dementia have shown inconsistent results. This study aimed to determine the effect of AF on the risk of developing dementia using a longitudinal, community-based, and stroke-free elderly cohort. METHODS AND RESULTS: The association of incident AF with the development of incident dementia was assessed from 2005 to 2012 in 262 611 dementia- and stroke-free participants aged ≥60 years in the Korea National Health Insurance Service-Senior cohort. Incident AF was observed in 10 435 participants over an observational period of 1 629 903 person-years (0.64%/year). During the observational period, the incidence of dementia was 4.1 and 2.7 per 100 person-years in the incident AF and propensity score-matched AF-free groups, respectively. After adjustment, the risk of dementia was significantly increased by incident AF with a hazard ratio (HR) of 1.52 95% confidence interval (CI) 1.43-1.63, even after censoring for stroke (1.27, 95% CI 1.18-1.37). Incident AF increased the risk of both Alzheimer (HR 1.31, 95% CI 1.20-1.43) and vascular dementia (HR 2.11, 95% CI 1.85-2.41). Among patients with incident AF, oral anticoagulant use was associated with a preventive effect on dementia development (HR 0.61, 95% CI 0.54-0.68), and an increasing CHA2DS2-VASc score was associated with a higher risk of dementia. CONCLUSION: Incident AF was associated with an increased risk of dementia, independent of clinical stroke in an elderly population. Oral anticoagulant use was linked with a decreased incidence of dementia.
“We found that the people who developed atrial fibrillation had a 50% increased risk of developing dementia compared to those who did not develop the condition; this increased risk remained even after we removed those who suffered a stroke from our calculations. This means that, among the general population, an extra 1.4 people per 100 of the population would develop dementia if they were diagnosed with atrial fibrillation. The risk occurred in people aged younger and older than 70 years.”
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Dongmin Kim
Pil‐Sung Yang
Hee Tae Yu
European Heart Journal
University of Liverpool
Yonsei University
Aalborg University
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Kim et al. (Tue,) conducted a cohort in Atrial fibrillation (n=262,611). Incident atrial fibrillation vs. Propensity score-matched AF-free group was evaluated on Incident dementia (HR 1.52, 95% CI 1.43-1.63). Incident atrial fibrillation significantly increased the risk of dementia in stroke-free elderly patients (HR 1.52; 95% CI 1.43-1.63), while oral anticoagulant use was associated with reduced risk.
www.synapsesocial.com/papers/69ec32a96763cbe2e0f529b0 — DOI: https://doi.org/10.1093/eurheartj/ehz386