Risk of dementia in stroke-free patients diagnosed with atrial fibrillation: data from a community-based cohort
Key result
Post-AF dementia is linked to ~190% higher mortality in stroke-free patients.
- n=2,837
Why the study?
The study was designed to estimate the incidence of dementia after first AF and its impact on survival in a community-based cohort.
What is the incidence of dementia after first atrial fibrillation in stroke-free patients, and its impact on survival?
Population
2837 adults diagnosed with first AF without cognitive dysfunction or stroke at onset
Design
Community-based cohort study
Follow-up
Median 4.6 years
Authors
Discussion
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Member takes
Implication
AF may increase dementia risk independent of stroke; leaves open whether rhythm control or anticoagulation alters this association.
Key Points
- To estimate the incidence of dementia after a first diagnosis of atrial fibrillation in stroke-free individuals and determine its impact on survival.
- Identified and followed N=2837 adult residents (mean age 71 ± 15 years) diagnosed with first atrial fibrillation (1986–2000) without baseline stroke or cognitive dysfunction up to 2004.
- Tracked incident dementia with interim stroke censored in survival models over a median follow-up of 4.6 years (IQR 1.5–7.9 years).
- Kaplan-Meier cumulative rates of dementia were 2.7% at 1 year and 10.5% at 5 years (299 cases total), strongly increasing with age (HR 2.8 per 10 years; 95% CI, 2.5–3.2) with no difference by sex (P = 0.52).
- Dementia onset post-atrial fibrillation was associated with a significant rise in mortality risk (HR 2.9; 95% CI, 2.5–3.3) after adjusting for comorbidities, independent of age (P = 0.75) and sex (P = 0.33).
Study Design
Type
Cohort (n=2,837)
Multicenter
No
Structured PICO
What is the incidence of dementia after first atrial fibrillation in stroke-free patients, and its impact on survival?
P
Population
2,837 adult residents with first atrial fibrillation and no prior cognitive dysfunction or stroke, followed for a median of 4.6 years.
O
Outcome
New detection of dementiahard clinical
Dementia is a common complication following a first diagnosis of atrial fibrillation even in the absence of stroke, and it significantly increases mortality risk.
Cite This Study
Miyasaka et al. (2007) conducted a cohort in first atrial fibrillation (n=2,837). First atrial fibrillation was evaluated on new detection of dementia. In stroke-free patients with first atrial fibrillation, the 5-year cumulative rate of new dementia was 10.5%, and post-AF dementia was associated with increased mortality (HR 2.9; 95% CI 2.5-3.3).