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

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

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
Volume40
Issue number28
DOIs
Publication statusPublished - 2019 Jan 1

Fingerprint

Atrial Fibrillation
Dementia
Stroke
Population
Confidence Intervals
National Health Programs
Anticoagulants
Social Adjustment
Propensity Score
Vascular Dementia
Incidence
Korea
Longitudinal Studies

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Kim, Dongmin ; Yang, Pil Sung ; Yu, Hee Tae ; Kim, Tae Hoon ; Jang, Eunsun ; Sung, Jung Hoon ; Pak, Hui Nam ; Lee, Myung Yong ; Lee, Moon Hyoung ; Lip, Gregory Y.H. ; Joung, Boyoung. / Risk of dementia in stroke-free patients diagnosed with atrial fibrillation : Data from a population-based cohort. In: European heart journal. 2019 ; Vol. 40, No. 28. pp. 2313-2323.
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title = "Risk of dementia in stroke-free patients diagnosed with atrial fibrillation: Data from a population-based cohort",
abstract = "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.",
author = "Dongmin Kim and Yang, {Pil Sung} and Yu, {Hee Tae} and Kim, {Tae Hoon} and Eunsun Jang and Sung, {Jung Hoon} and Pak, {Hui Nam} and Lee, {Myung Yong} and Lee, {Moon Hyoung} and Lip, {Gregory Y.H.} and Boyoung Joung",
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Risk of dementia in stroke-free patients diagnosed with atrial fibrillation : Data from a population-based cohort. / Kim, Dongmin; Yang, Pil Sung; Yu, Hee Tae; Kim, Tae Hoon; Jang, Eunsun; Sung, Jung Hoon; Pak, Hui Nam; Lee, Myung Yong; Lee, Moon Hyoung; Lip, Gregory Y.H.; Joung, Boyoung.

In: European heart journal, Vol. 40, No. 28, 01.01.2019, p. 2313-2323.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Risk of dementia in stroke-free patients diagnosed with atrial fibrillation

T2 - Data from a population-based cohort

AU - Kim, Dongmin

AU - Yang, Pil Sung

AU - Yu, Hee Tae

AU - Kim, Tae Hoon

AU - Jang, Eunsun

AU - Sung, Jung Hoon

AU - Pak, Hui Nam

AU - Lee, Myung Yong

AU - Lee, Moon Hyoung

AU - Lip, Gregory Y.H.

AU - Joung, Boyoung

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

AB - 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.

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