Atrial Fibrillation Linked to Dementia, Especially When Diagnosed Before Age 65 Years

METHODOLOGY:

  • This prospective, population-based cohort study leveraged data from 433,746 UK Biobank participants (55% women), including 30,601 with AF, who were followed for a median of 12.6 years
  • Incident cases of dementia were determined through linkage from multiple databases.
  • Cox proportional hazards models and propensity score matching were used to estimate the association between age at onset of AF and incident dementia.

TAKEAWAY:

  • During follow-up, new-onset dementia occurred in 5898 participants (2546 with Alzheimer's disease [AD] and 1211 with vascular dementia [VD]), of which, 1031 had AF (350 with AD; 320 with VD).

  • Compared with participants without AF, those with AF had a 42% higher risk for all-cause dementia (adjusted hazard ratio [aHR], 1.42; P < .001) and more than double the risk for VD (aHR, 2.06; P < .001), but no significantly higher risk for AD.

  • Younger age at AF onset was associated with higher risks for all-cause dementia, AD and VD, with aHRs per 10-year decrease of 1.23, 1.27, and 1.35, respectively (P < .001 for all).

  • After propensity score matching, AF onset before age 65 years had the highest risk for all-cause dementia (aHR, 1.82; P < .001), followed by AF onset at age 65-74 years (aHR, 1.47; P < .001). Similar results were seen in AD and VD.

    IN PRACTICE:

    The findings indicate that careful monitoring of cognitive function for patients with a younger AF onset age, particularly those diagnosed with AF before age 65 years, is important to attenuate the risk of subsequent dementia.

     

    https://www.medscape.com/viewarticle/998428