Risk of dementia in stroke-free patients diagnosed with atrial fibrillation: Data from a community-based cohort

Yoko Miyasaka, Marion E. Barnes, Ronald Carl Petersen, Stephen S. Cha, Kent R Bailey, Bernard J. Gersh, Grace Casaclang-Verzosa, Walter P. Abhayaratna, James B. Seward, Toshiji Iwasaka, Teresa S M Tsang

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Abstract

Aims: To estimate the incidence of dementia after the first atrial fibrillation (AF), and its impact on survival in a community-based cohort. Methods and results: Olmsted County, Minnesota adult residents diagnosed with first AF during 1986-2000 were identified, and followed until 2004. The primary outcome was new detection of dementia. Interim stroke was censored in the analyses. Of 2837 subjects (71 ± 15 years old) diagnosed with first AF and without any evidence of cognitive dysfunction or stroke at the time of AF onset, 299 were diagnosed with dementia during a median follow-up of 4.6 years [interquartile (IQR) range 1.5-7.9 years], and 1638 died. The Kaplan-Meier cumulative rate of dementia was 2.7% at 1 year and 10.5% at 5 years. After adjustment for age and sex, dementia was strongly related to advancing age [hazard ratio (HR)/10 years, 2.8; 95% confidence interval (CI), 2.5-3.2], but did not vary with sex (P = 0.52). The occurrence of post-AF dementia was associated with significantly increased mortality risk (HR 2.9; 95% CI 2.5-3.3), even after adjustment for multiple comorbidities, and did not vary with age (P = 0.75) or sex (P = 0.33). Conclusion: Dementia appeared common following the diagnosis of first AF, and was associated with premature death.

Original languageEnglish (US)
Pages (from-to)1962-1967
Number of pages6
JournalEuropean Heart Journal
Volume28
Issue number16
DOIs
StatePublished - Aug 2007

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Atrial Fibrillation
Dementia
Stroke
Confidence Intervals
Premature Mortality
Comorbidity
Odds Ratio
Survival
Mortality
Incidence

Keywords

  • Atrial fibrillation
  • Dementia
  • Incidence
  • Prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Risk of dementia in stroke-free patients diagnosed with atrial fibrillation : Data from a community-based cohort. / Miyasaka, Yoko; Barnes, Marion E.; Petersen, Ronald Carl; Cha, Stephen S.; Bailey, Kent R; Gersh, Bernard J.; Casaclang-Verzosa, Grace; Abhayaratna, Walter P.; Seward, James B.; Iwasaka, Toshiji; Tsang, Teresa S M.

In: European Heart Journal, Vol. 28, No. 16, 08.2007, p. 1962-1967.

Research output: Contribution to journalArticle

Miyasaka, Y, Barnes, ME, Petersen, RC, Cha, SS, Bailey, KR, Gersh, BJ, Casaclang-Verzosa, G, Abhayaratna, WP, Seward, JB, Iwasaka, T & Tsang, TSM 2007, 'Risk of dementia in stroke-free patients diagnosed with atrial fibrillation: Data from a community-based cohort', European Heart Journal, vol. 28, no. 16, pp. 1962-1967. https://doi.org/10.1093/eurheartj/ehm012
Miyasaka, Yoko ; Barnes, Marion E. ; Petersen, Ronald Carl ; Cha, Stephen S. ; Bailey, Kent R ; Gersh, Bernard J. ; Casaclang-Verzosa, Grace ; Abhayaratna, Walter P. ; Seward, James B. ; Iwasaka, Toshiji ; Tsang, Teresa S M. / Risk of dementia in stroke-free patients diagnosed with atrial fibrillation : Data from a community-based cohort. In: European Heart Journal. 2007 ; Vol. 28, No. 16. pp. 1962-1967.
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AU - Cha, Stephen S.

AU - Bailey, Kent R

AU - Gersh, Bernard J.

AU - Casaclang-Verzosa, Grace

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AU - Iwasaka, Toshiji

AU - Tsang, Teresa S M

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N2 - Aims: To estimate the incidence of dementia after the first atrial fibrillation (AF), and its impact on survival in a community-based cohort. Methods and results: Olmsted County, Minnesota adult residents diagnosed with first AF during 1986-2000 were identified, and followed until 2004. The primary outcome was new detection of dementia. Interim stroke was censored in the analyses. Of 2837 subjects (71 ± 15 years old) diagnosed with first AF and without any evidence of cognitive dysfunction or stroke at the time of AF onset, 299 were diagnosed with dementia during a median follow-up of 4.6 years [interquartile (IQR) range 1.5-7.9 years], and 1638 died. The Kaplan-Meier cumulative rate of dementia was 2.7% at 1 year and 10.5% at 5 years. After adjustment for age and sex, dementia was strongly related to advancing age [hazard ratio (HR)/10 years, 2.8; 95% confidence interval (CI), 2.5-3.2], but did not vary with sex (P = 0.52). The occurrence of post-AF dementia was associated with significantly increased mortality risk (HR 2.9; 95% CI 2.5-3.3), even after adjustment for multiple comorbidities, and did not vary with age (P = 0.75) or sex (P = 0.33). Conclusion: Dementia appeared common following the diagnosis of first AF, and was associated with premature death.

AB - Aims: To estimate the incidence of dementia after the first atrial fibrillation (AF), and its impact on survival in a community-based cohort. Methods and results: Olmsted County, Minnesota adult residents diagnosed with first AF during 1986-2000 were identified, and followed until 2004. The primary outcome was new detection of dementia. Interim stroke was censored in the analyses. Of 2837 subjects (71 ± 15 years old) diagnosed with first AF and without any evidence of cognitive dysfunction or stroke at the time of AF onset, 299 were diagnosed with dementia during a median follow-up of 4.6 years [interquartile (IQR) range 1.5-7.9 years], and 1638 died. The Kaplan-Meier cumulative rate of dementia was 2.7% at 1 year and 10.5% at 5 years. After adjustment for age and sex, dementia was strongly related to advancing age [hazard ratio (HR)/10 years, 2.8; 95% confidence interval (CI), 2.5-3.2], but did not vary with sex (P = 0.52). The occurrence of post-AF dementia was associated with significantly increased mortality risk (HR 2.9; 95% CI 2.5-3.3), even after adjustment for multiple comorbidities, and did not vary with age (P = 0.75) or sex (P = 0.33). Conclusion: Dementia appeared common following the diagnosis of first AF, and was associated with premature death.

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