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Atrial fibrillation and cognitive decline: a longitudinal cohort study.
Tuesday,2013-08-13 18:30 America/Los_Angeles — eenright
| Title | Atrial fibrillation and cognitive decline: a longitudinal cohort study. |
| Publication Type | Journal Article |
| Year of Publication | 2013 |
| Authors | Thacker, EL, McKnight, B, Psaty, BM, Longstreth, WT, Sitlani, CM, Dublin, S, Arnold, AM, Fitzpatrick, AL, Gottesman, RF, Heckbert, SR |
| Journal | Neurology |
| Volume | 81 |
| Issue | 2 |
| Pagination | 119-25 |
| Date Published | 2013 Jul 09 |
| ISSN | 1526-632X |
| Keywords | Age Factors, Aged, Aged, 80 and over, Atrial Fibrillation, Cognition Disorders, Comorbidity, Female, Humans, Incidence, Longitudinal Studies, Luria-Nebraska Neuropsychological Battery, Male, Predictive Value of Tests |
| Abstract | <p><b>OBJECTIVE: </b>We sought to determine whether in the absence of clinical stroke, people with atrial fibrillation experience faster cognitive decline than people without atrial fibrillation.</p><p><b>METHODS: </b>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.</p><p><b>RESULTS: </b>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).</p><p><b>CONCLUSIONS: </b>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.</p> |
| DOI | 10.1212/WNL.0b013e31829a33d1 |
| Alternate Journal | Neurology |
| PubMed ID | 23739229 |
| PubMed Central ID | PMC3770176 |
| Grant List | N01HC55222 / HC / NHLBI NIH HHS / United States N01HC85080 / HC / NHLBI NIH HHS / United States K23AG028954 / AG / NIA NIH HHS / United States T32HL007902 / HL / NHLBI NIH HHS / United States N01HC85081 / HC / NHLBI NIH HHS / United States N01HC85079 / HC / NHLBI NIH HHS / United States N01HC85086 / HC / NHLBI NIH HHS / United States HL102214 / HL / NHLBI NIH HHS / United States N01HC85082 / HC / NHLBI NIH HHS / United States HHSN268200800007C / / PHS HHS / United States HHSN268201200036C / / PHS HHS / United States HL080295 / HL / NHLBI NIH HHS / United States N01HC85083 / HC / NHLBI NIH HHS / United States AG023629 / AG / NIA NIH HHS / United States |