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Meta-Analysis
. 2021 Oct;36(10):1488-1500.
doi: 10.1002/gps.5582. Epub 2021 May 27.

Risk of dementia in patients with atrial fibrillation: Short versus long follow-up. A systematic review and meta-analysis

Marco Zuin  1 , Loris Roncon  2 , Angelina Passaro  1 , Cristina Bosi  1 , Carlo Cervellati  1 , Giovanni Zuliani  1
Affiliations
Meta-Analysis

Risk of dementia in patients with atrial fibrillation: Short versus long follow-up. A systematic review and meta-analysis

Marco Zuin et al. Int J Geriatr Psychiatry. 2021 Oct.

Abstract

Background: No previous meta-analyses have compared the risk of dementia, due to an underlying atrial fibrillation (AF), in the short-term versus the long-term period.

Aim: To perform an update meta-analysis of studies examining the association between AF and dementia and the relative impact of follow-up period.

Methods: Data were obtained searching MEDLINE and Scopus for all investigations published between 1 January 2000 and March 1, 2021 reporting the risk of dementia in AF patients. The following MeSH terms were used for the search: "Atrial Fibrillation" AND "Dementia" OR "Alzheimer's disease". From each study, the adjusted hazard ratio (aHR) with the related 95% confidence interval (CI) was pooled using a random effect model.

Results: The analysis was carried out on 18 studies involving 3.559.349 subjects, of which 902.741 (25.3%) developed dementia during follow-up. A random effect model revealed an aHR of 1.40 (95% CI: 1.27-1.54, p < 0.0001; I2 = 93.5%) for dementia in subjects with AF. Stratifying the studies according to follow-up duration, those having a follow-up ≥10 years showed an aHR for dementia of 1.37 (95% CI: 1.21-1.55, p < 0.0001, I2 = 96.6%), while those with a follow-up duration <10 years has a slightly higher aHR for dementia (HR: 1.59, 95%CI: 1.51-1.67, p < 0.0001, I2 = 49%). Nine studies showed that the aHR for Alzheimer's disease (AD) in AF patients was 1.30 (95%CI: 1.12-1.51, p < 0.0001, I2 = 87.6%).

Conclusions: Evidence suggests that patients with AF have an increased risk of developing dementia and AD. The risk of dementia was slightly higher when the follow-up was shorter than 10 years.

Keywords: atrial fibrillation; dementia; elderly; meta-analysis; systematic review.

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Conflict of interest statement

All authors declare that they have no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Preferred reporting items for systematic reviews and meta‐analyses (PRISMA) flow chart
FIGURE 2
FIGURE 2
Forest plots investigating the overall risk of dementia in atrial fibrillation patients
FIGURE 3
FIGURE 3
Meta‐regression analysis examining the risk of dementia, due to an underlying atrial fibrillation, respect to the follow‐up length of revised studies
FIGURE 4
FIGURE 4
Study with follow‐up ≥10 (A) and <10 years (B) investigating the relationship between atrial fibrillation and the risk of dementia
FIGURE 5
FIGURE 5
Association between atrial fibrillation and Alzheimer disease risk
See this image and copyright information in PMC

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