02861nas a2200409 4500008004100000022001400041245007600055210006900131260001600200300001100216490000700227520170000234653001601934653000901950653002201959653002401981653002402005653001602029653001102045653001102056653001402067653002502081653004602106653000902152653003002161100002102191700002202212700002002234700002002254700002402274700001902298700002102317700002802338700002602366700002302392856003602415 2013 eng d a1526-632X00aAtrial fibrillation and cognitive decline: a longitudinal cohort study.0 aAtrial fibrillation and cognitive decline a longitudinal cohort c2013 Jul 09 a119-250 v813 a
OBJECTIVE: We sought to determine whether in the absence of clinical stroke, people with atrial fibrillation experience faster cognitive decline than people without atrial fibrillation.
METHODS: We conducted a longitudinal analysis in the Cardiovascular Health Study, a community-based study of 5,888 men and women aged 65 years and older, enrolled in 1989/1990 or 1992/1993. Participants did not have atrial fibrillation or a history of stroke at baseline. Participants were censored when they experienced incident clinical stroke. Incident atrial fibrillation was identified by hospital discharge diagnosis codes and annual study ECGs. The main outcome was rate of decline in mean scores on the 100-point Modified Mini-Mental State Examination (3MSE), administered annually up to 9 times.
RESULTS: Analyses included 5,150 participants, of whom 552 (10.7%) developed incident atrial fibrillation during a mean of 7 years of follow-up. Mean 3MSE scores declined faster after incident atrial fibrillation compared with no prior atrial fibrillation. For example, the predicted 5-year decline in mean 3MSE score from age 80 to age 85 was -6.4 points (95% confidence interval [CI]: -7.0, -5.9) for participants without a history of atrial fibrillation, but was -10.3 points (95% CI: -11.8, -8.9) for participants experiencing incident atrial fibrillation at age 80, a 5-year difference of -3.9 points (95% CI: -5.3, -2.5).
CONCLUSIONS: In the absence of clinical stroke, people with incident atrial fibrillation are likely to reach thresholds of cognitive impairment or dementia at earlier ages than people with no history of atrial fibrillation.
10aAge Factors10aAged10aAged, 80 and over10aAtrial Fibrillation10aCognition Disorders10aComorbidity10aFemale10aHumans10aIncidence10aLongitudinal Studies10aLuria-Nebraska Neuropsychological Battery10aMale10aPredictive Value of Tests1 aThacker, Evan, L1 aMcKnight, Barbara1 aPsaty, Bruce, M1 aLongstreth, W T1 aSitlani, Colleen, M1 aDublin, Sascha1 aArnold, Alice, M1 aFitzpatrick, Annette, L1 aGottesman, Rebecca, F1 aHeckbert, Susan, R uhttps://chs-nhlbi.org/node/6002