Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Nov 8:11:305.
doi: 10.3389/fnagi.2019.00305. eCollection 2019.

Association Between Atrial Fibrillation and Dementia: A Meta-Analysis

Md Mohaimenul Islam  1   2   3 , Tahmina Nasrin Poly  1   2   3 , Bruno Andreas Walther  4 , Hsuan-Chia Yang  1   2   3 , Chieh Chen Wu  1   2 , Ming-Chin Lin  1   5 , Shuo-Chen Chien  1   2 , Yu-Chuan Li  1   2   3   6   7
Affiliations

Association Between Atrial Fibrillation and Dementia: A Meta-Analysis

Md Mohaimenul Islam et al. Front Aging Neurosci. .

Abstract

Background: A potential evidence from previous epidemiological studies remains conflicting findings regarding the association between atrial fibrillation (AF) and dementia risk. We, therefore, carried out a meta-analysis of relevant studies to investigate the magnitude of the association between AF and dementia risk. Methods: We performed a systematic literature search of PubMed, EMBASE, and Google Scholar for potential studies between January 1, 1990, and December 31, 2018, with no restriction on the publication language. All potential studies were independently assessed by two reviewers. We only included observational studies that calculated the odds ratio (OR)/hazards ratio (HR) for dementia associated with atrial fibrillation. We first assessed the heterogeneity among study-specific HRs using the Q statistic and I 2 statistic. We then used the random-effects model to obtain the overall HR and its 95% CI for all studies. We also tested and corrected for publication bias by funnel plot-based methods. The quality of each study was assessed with the Newcastle Ottawa Scale. Results: A total of 16 studies with 2,415,356 individuals, and approximately 200,653 cases of incidence dementia were included in this study. Patients with AF had a greater risk of incidence dementia than those without AF (random-effect hazard ratio HR: 1.36, 95% CI: 1.23-1.51, p < 0.0001; I 2 = 83.58). Funnel plot and Egger test did not reveal significant publication bias. However, limitations of the study included high heterogeneity and varying degrees of confounder adjustment across individual studies. Conclusion: This study serves as added evidence supporting the hypothesis that AF is associated with an increased risk of dementia. More studies are needed to establish whether optimal treatment of AF can reduce or mitigate the risk of dementia.

Keywords: atrial fibrillation; cardiac arrhythmia; cardiac disease; dementia; hypertension; stroke.

PubMed Disclaimer

Figures

Figure 1
Figure 1
PRISMA flow diagram for study selection.
Figure 2
Figure 2
Methodological quality assessment of RCT.
Figure 3
Figure 3
Association between AF and dementia risk.
Figure 4
Figure 4
Association between AF and Alzheimer disease risk.
Figure 5
Figure 5
Risk of dementia in patients with AF based on follow-up period: (A) more than five years' follow-up period, (B) <5 years' follow-up period.
Figure 6
Figure 6
Association between AF and dementia based on study design: (A) cohort study design, (B) randomized control trial.
Figure 7
Figure 7
Risk of dementia based on region: (A) Europe, (B) North America.
Figure 8
Figure 8
Funnel plot.
Figure 9
Figure 9
Biological mechanism between AF and dementia.
See this image and copyright information in PMC

References

    1. Akinyemi R. O., Mukaetova-Ladinska E. B., Attems J., Ihara M., Kalaria R. N. (2013). Vascular risk factors and neurodegeneration in ageing related dementias: Alzheimer's disease and vascular dementia. Curr. Alzheimer Res. 10, 642–653. 10.2174/15672050113109990037 - DOI - PubMed
    1. Alosco M. L., Spitznagel M. B., Sweet L. H., Josephson R., Hughes J., Gunstad J. (2015). Atrial fibrillation exacerbates cognitive dysfunction and cerebral perfusion in heart failure. Pacing Clin. Electrophysiol. 38, 178–186. 10.1111/pace.12543 - DOI - PMC - PubMed
    1. Banik A., Brown R. E., Bamburg J., Lahiri D. K., Khurana D., Friedland R. P., et al. . (2015). Translation of pre-clinical studies into successful clinical trials for Alzheimer's disease: what are the roadblocks and how can they be overcome? J. Alzheimer's Dis. 47, 815–843. 10.3233/JAD-150136 - DOI - PubMed
    1. Bell R. D., Zlokovic B. V. (2009). Neurovascular mechanisms and blood–brain barrier disorder in Alzheimer's disease. Acta Neuropathol. 118, 103–113. 10.1007/s00401-009-0522-3 - DOI - PMC - PubMed
    1. Bunch T. J., Crandall B. G., Weiss J. P., May H. T., Bair T. L., Osborn J. S., et al. . (2011). Patients treated with catheter ablation for atrial fibrillation have long-term rates of death, stroke, and dementia similar to patients without atrial fibrillation. J. Cardiovasc. Electrophysiol. 22, 839–845. 10.1111/j.1540-8167.2011.02035.x - DOI - PubMed

Publication types

LinkOut - more resources