TY - JOUR
T1 - Atrial fibrillation and cognitive decline
AU - Thacker, Evan L.
AU - McKnight, Barbara
AU - Psaty, Bruce M.
AU - Longstreth, W. T.
AU - Sitlani, Colleen M.
AU - Dublin, Sascha
AU - Arnold, Alice M.
AU - Fitzpatrick, Annette L.
AU - Gottesman, Rebecca F.
AU - Heckbert, Susan R.
PY - 2013/7/9
Y1 - 2013/7/9
N2 - 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: Weconducted a longitudinal analysis in theCardiovascularHealth 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-pointModifiedMini-Mental State Examination (3MSE), administered annually up to 9 times. Results: Analyses included 5,150 participants, of whom552 (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 26.4 points (95%confidence interval [CI]: 27.0, 25.9) for participants without a history of atrial fibrillation, but was 210.3 points (95% CI: 211.8, 28.9) for participants experiencing incident atrial fibrillation at age 80, a 5-year difference of 23.9 points (95% CI: 25.3, 22.5). 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.
AB - 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: Weconducted a longitudinal analysis in theCardiovascularHealth 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-pointModifiedMini-Mental State Examination (3MSE), administered annually up to 9 times. Results: Analyses included 5,150 participants, of whom552 (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 26.4 points (95%confidence interval [CI]: 27.0, 25.9) for participants without a history of atrial fibrillation, but was 210.3 points (95% CI: 211.8, 28.9) for participants experiencing incident atrial fibrillation at age 80, a 5-year difference of 23.9 points (95% CI: 25.3, 22.5). 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.
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U2 - 10.1212/WNL.0b013e31829a33d1
DO - 10.1212/WNL.0b013e31829a33d1
M3 - Article
C2 - 23739229
AN - SCOPUS:84881297021
SN - 0028-3878
VL - 81
SP - 119
EP - 125
JO - Neurology
JF - Neurology
IS - 2
ER -