Key result
Incident atrial fibrillation was not significantly associated with a decline in cognitive function (difference in mean annual change 0.222, p=0.19) in adults with mild-to-moderate chronic kidney disease.
Why the study?
While AF is an independent risk factor for cognitive decline in the general population, this relationship had not been examined in adults with CKD.
Does incident atrial fibrillation accelerate cognitive decline in adults with chronic kidney disease?
Cohort (n=3,254)
Yes
Does incident atrial fibrillation accelerate cognitive decline in adults with chronic kidney disease?
In adults with mild-to-moderate chronic kidney disease, incident atrial fibrillation was not significantly associated with a decline in global cognitive function over a median follow-up of 6.8 years.
Answers are grounded in this paper and cite their sources.
Incident AF was not associated with cognitive decline in CKD; hypothesis-generating and does not yet inform clinical practice.
Background Studies in the general population suggest that atrial fibrillation (AF) is an independent risk factor for decline in cognitive function, but this relationship has not been examined in adults with chronic kidney disease (CKD). We investigated the association between incident AF and changes in cognitive function over time in this population. Methods and Results We studied a subgroup of 3254 adults participating in the Chronic Renal Insufficiency Cohort Study. Incident AF was ascertained by 12-lead electrocardiogram (ECG) obtained at a study visit and/or identification of a hospitalization with AF during follow-up. Cognitive function was assessed biennially using the Modified Mini-Mental State Exam. Linear mixed effects regression was used to evaluate the association between incident AF and longitudinal change in cognitive function. Compared with individuals without incident AF ( n = 3158), those with incident AF ( n = 96) were older, had a higher prevalence of cardiovascular disease and hypertension, and lower estimated glomerular filtration rate. After median follow-up of 6.8 years, we observed no significant multivariable association between incident AF and change in cognitive function test score. Conclusion In this cohort of adults with CKD, incident AF was not associated with a decline in cognitive function.
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McCauley et al. (2021) conducted a cohort in Chronic Kidney Disease (n=3,254). Incident Atrial Fibrillation vs. No incident atrial fibrillation was evaluated on Longitudinal change in Modified Mini-Mental State Exam (3MS) score (β 0.222, 95% CI -0.108 to 0.553, p=0.19). Incident atrial fibrillation was not significantly associated with a decline in cognitive function (difference in mean annual change 0.222, p=0.19) in adults with mild-to-moderate chronic kidney disease.
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