From over 4.3 million people in the UK primary electronic health record (EHR) database, researchers identified 233,833 (5.4%) with AF (mean age, 74.2 years) and randomly selected one age- and sex-matched control person without AF for each AF case patient.
The primary outcome was incidence of mild cognitive impairment (MCI).
The authors adjusted for age, sex, year at study entry, socioeconomic status, smoking, and a number of comorbid conditions.
During a median of 5.3 years of follow-up, there were 4269 incident MCI cases among both AF and non-AF patients.
Individuals with AF had a higher risk of MCI than those without AF (adjusted hazard ratio [aHR], 1.45; 95% CI, 1.35 – 1.56).
Besides AF, older age (risk ratio [RR], 1.08) and history of depression (RR, 1.44) were associated with greater risk of MCI, as were female sex, greater socioeconomic deprivation, stroke, and multimorbidity, including, for example, diabetes, hypercholesterolemia, and peripheral artery disease (all P < .001).
Individuals with AF who received oral anticoagulants or amiodarone were not at increased risk of MCI, as was the case for those treated with digoxin.
Individuals with AF and MCI were at greater risk of dementia (aHR, 1.25; 95% CI, 1.09 – 1.42). Sex, smoking, chronic kidney disease, and multi-comorbidity were among factors linked to elevated dementia risk.
The findings emphasize the association of multi-comorbidity and cardiovascular risk factors with development of MCI and progression to dementia in AF patients, the authors write. They note that the data suggest combining anticoagulation and symptom and comorbidity management may prevent cognitive deterioration.
https://www.medscape.com/viewarticle/998073
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