Risk of dementia in stroke-free patients diagnosed with atrial fibrillation: Data from a population-based cohort

Dongmin Kim, Pil Sung Yang, Hee Tae Yu, Tae Hoon Kim, Eunsun Jang, Jung Hoon Sung, Hui Nam Pak, Myung Yong Lee, Moon Hyoung Lee, Gregory Y.H. Lip, Boyoung Joung

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108 Citations (Scopus)


Aims: Atrial fibrillation (AF) is generally regarded as a risk factor for dementia, though longitudinal studies assessing the association between AF and dementia have shown inconsistent results. This study aimed to determine the effect of AF on the risk of developing dementia using a longitudinal, community-based, and stroke-free elderly cohort. Methods and results: The association of incident AF with the development of incident dementia was assessed from 2005 to 2012 in 262 611 dementia-and stroke-free participants aged ≥60 years in the Korea National Health Insurance Service-Senior cohort. Incident AF was observed in 10 435 participants over an observational period of 1 629 903 person-years (0.64%/year). During the observational period, the incidence of dementia was 4.1 and 2.7 per 100 person-years in the incident AF and propensity score-matched AF-free groups, respectively. After adjustment, the risk of dementia was significantly increased by incident AF with a hazard ratio (HR) of 1.52 [95% confidence interval (CI) 1.43-1.63], even after censoring for stroke (1.27, 95% CI 1.18-1.37). Incident AF increased the risk of both Alzheimer (HR 1.31, 95% CI 1.20-1.43) and vascular dementia (HR 2.11, 95% CI 1.85-2.41). Among patients with incident AF, oral anticoagulant use was associated with a preventive effect on dementia development (HR 0.61, 95% CI 0.54-0.68), and an increasing CHA2DS2-VASc score was associated with a higher risk of dementia. Conclusion: Incident AF was associated with an increased risk of dementia, independent of clinical stroke in an elderly population. Oral anticoagulant use was linked with a decreased incidence of dementia.

Original languageEnglish
Pages (from-to)2313-2323
Number of pages11
JournalEuropean heart journal
Issue number28
Publication statusPublished - 2019 Jul 21

Bibliographical note

Funding Information:
This study was supported by a research grant from the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education, Science and Technology (NRF-2017R1A2B3003303), and grants from the Korean Healthcare Technology R&D project funded by the Ministry of Health & Welfare (HI16C0058, HI15C1200).

Publisher Copyright:
© 2019 Published on behalf of the European Society of Cardiology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine


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