Key result
AF linked to ~26% higher risk of progression to mild cognitive impairment in women.
Why the study?
It is unclear whether sex differences exist in cognitive disease progression in mild cognitive impairment and dementia associated with AF.
Does atrial fibrillation increase the rate of cognitive disease progression in women compared to men?
Cohort (n=43,630)
Yes
Does atrial fibrillation increase the rate of cognitive disease progression in women compared to men?
Atrial fibrillation is associated with a significantly faster progression to mild cognitive impairment and vascular dementia in older women, suggesting a sex-specific vulnerability to AF-related cognitive decline.
AF may heighten cognitive progression risk in women; hypothesis-generating and should not yet alter practice or guidelines.
INTRODUCTION: It is unclear if sex differences exist in cognitive disease progression in mild cognitive impairment (MCI) and dementia associated with atrial fibrillation (AF). METHODS: Using a variety of statistical methods, we examined sex differences between AF and neuropsychological tests and cognitive disease progression, using the National Alzheimer's Coordinating Center data (N = 43,630). RESULTS: AF is associated with higher odds of dementia (odds ratio [OR] 3.00, 95% confidence interval [CI] [1.22, 7.37] in women and MCI in women (OR 3.43, 95% CI [1.55, 7.55]) versus men. Women with AF and normal baseline cognition had a higher risk of disease progression (hazard ratio [HR] 1.26, 95% CI [1.06, 1.50]) from normal to MCI and from MCI to vascular dementia (HR3.27, 95% CI [1.89, 5.65]) than men with AF or men and women without AF. DISCUSSION: AF was associated with more rapid progression to MCI and dementia in women, but more research is needed to confirm these findings.
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Wood et al. (2023) conducted a cohort in Atrial fibrillation and cognitive disease progression (n=43,630). Atrial fibrillation vs. No atrial fibrillation / Male sex was evaluated on Disease progression from normal cognition to mild cognitive impairment (MCI) in women with AF (HR 1.26, 95% CI 1.06-1.50). Atrial fibrillation was associated with a higher risk of disease progression from normal cognition to mild cognitive impairment (HR 1.26) and from mild cognitive impairment to vascular dementia (HR 3.27) in women.
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