Atrial fibrillation increases the risk of dementia amongst older adults even in the absence of stroke

Background Atrial fibrillation increases risk of stroke, and thus risk of cognitive impairment and dementia. Emerging evidence suggests an association also in the absence of stroke. We aimed to examine the association between atrial fibrillation and incident dementia, with and without exclusion of i...

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Bibliographic Details
Published in:Journal of internal medicine 2019-07, Vol.286 (1), p.101-110
Main Authors: Rydén, L., Zettergren, A., Seidu, N. M., Guo, X., Kern, S., Blennow, K., Zetterberg, H., Sacuiu, S., Skoog, I.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Alzheimer′s Disease
Apolipoprotein E
atrial fibrillation
Atrial Fibrillation - complications
Brain
Cardiac arrhythmia
cardiology
Cognitive ability
Cohort Studies
Dementia
Dementia - epidemiology
Dementia - etiology
Dementia disorders
Electrocardiography
epidemiology
Female
Fibrillation
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Genetic factors
Health risks
Humans
Male
Men
Older people
Public Health, Global Health, Social Medicine and Epidemiology
Risk
Risk Assessment
Sex
Signs and symptoms
Stroke
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Summary:Background Atrial fibrillation increases risk of stroke, and thus risk of cognitive impairment and dementia. Emerging evidence suggests an association also in the absence of stroke. We aimed to examine the association between atrial fibrillation and incident dementia, with and without exclusion of individuals with stroke, and if sex and genetic factors modify the possible association. Methods In 2000–2001, a population‐based sample of 70‐year‐olds (N = 561) underwent comprehensive somatic and neuropsychiatric examinations, as part of the Gothenburg H70 Birth Cohort Studies. Participants were followed up at age 75 and 79. Atrial fibrillation at baseline was identified through ECG, proxy‐reports and the National Patient Register (NPR). Stroke at baseline and follow‐up was identified through self‐reports, proxy‐reports and the NPR. Dementia at baseline and follow‐up was diagnosed according to the DSM‐III‐R criteria based on neuropsychiatric examinations, proxy‐reports and the NPR. Results Individuals with atrial fibrillation had an almost threefold increased risk of dementia during 12‐year follow‐up (HR 2.8; 95% CI 1.3–5.7; P = 0.004), and this risk remained after excluding individuals with stroke at baseline and follow‐up. After stratification for sex, the association was only found amongst men (HR 4.6; 95% CI 1.9–11.2; P 
ISSN:0954-6820
1365-2796
1365-2796
DOI:10.1111/joim.12902