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. 2011 Aug;59(8):1369-75.
doi: 10.1111/j.1532-5415.2011.03508.x. Epub 2011 Aug 1.

Atrial fibrillation and risk of dementia: a prospective cohort study

Sascha Dublin  1 , Melissa L Anderson, Sebastien J Haneuse, Susan R Heckbert, Paul K Crane, John C S Breitner, Wayne McCormick, James D Bowen, Linda Teri, Susan M McCurry, Eric B Larson
Affiliations

Atrial fibrillation and risk of dementia: a prospective cohort study

Sascha Dublin et al. J Am Geriatr Soc. 2011 Aug.

Abstract

Objectives: To determine whether atrial fibrillation (AF) is associated with risk of incident dementia or Alzheimer's disease (AD), beyond its effect on stroke.

Design: Prospective cohort study.

Setting: An integrated healthcare delivery system.

Participants: A population-based sample of 3,045 community-dwelling adults aged 65 and older without dementia or clinical stroke followed from 1994 to 2008.

Measurements: AF was identified from health plan electronic data using International Classification of Diseases, Ninth Revision, codes from inpatient and outpatient encounters. Covariates came from self-report, study measures, and health plan data. Participants were screened every 2 years using the Cognitive Abilities Screening Instrument (range 0-100), with detailed neuropsychological and clinical assessment of those scoring less than 86. A multidisciplinary consensus committee determined diagnoses of all-cause dementia and possible or probable AD using standard research criteria.

Results: AF was present in 132 (4.3%) participants at baseline and was diagnosed in 370 (12.2%) more over a mean of 6.8 years of follow-up; 572 participants (18.8%) developed dementia (449 with AD). The adjusted hazard ratio associated with AF was 1.38 (95% confidence interval (CI)=1.10-1.73) for all-cause dementia and 1.50 (95% CI=1.16-1.94) for possible or probable AD. Results were similar for participants with and without clinically recognized stroke during follow-up and in sensitivity analyses examining only probable AD.

Conclusion: AF is associated with higher risk of developing AD and dementia. Future studies should examine whether specific treatments, including optimal anticoagulation, can decrease this risk.

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Conflict of interest statement

Potential conflicts of interest: Dr. Dublin has received a Merck/American Geriatrics Society New Investigator Award. Other authors have no conflicts of interest to disclose.

Figures

Figure
Figure. Selection of Study Subjects
Abbreviations: ACT, Adult Changes in Thought; GH, Group Health.
See this image and copyright information in PMC

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