Atrial fibrillation and cognitive decline

Evan L. Thacker, Barbara McKnight, Bruce M. Psaty, W. T. Longstreth, Colleen M. Sitlani, Sascha Dublin, Alice M. Arnold, Annette L. Fitzpatrick, Rebecca F Gottesman, Susan R. Heckbert

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)119-125
Number of pages7
JournalNeurology
Volume81
Issue number2
DOIs
StatePublished - Jul 9 2013

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Atrial Fibrillation
Stroke
Confidence Intervals
Cognitive Dysfunction
Confidence Interval
History
Dementia
Electrocardiography

ASJC Scopus subject areas

  • Clinical Neurology
  • Arts and Humanities (miscellaneous)

Cite this

Thacker, E. L., McKnight, B., Psaty, B. M., Longstreth, W. T., Sitlani, C. M., Dublin, S., ... Heckbert, S. R. (2013). Atrial fibrillation and cognitive decline. Neurology, 81(2), 119-125. https://doi.org/10.1212/WNL.0b013e31829a33d1

Atrial fibrillation and cognitive decline. / Thacker, Evan L.; McKnight, Barbara; Psaty, Bruce M.; Longstreth, W. T.; Sitlani, Colleen M.; Dublin, Sascha; Arnold, Alice M.; Fitzpatrick, Annette L.; Gottesman, Rebecca F; Heckbert, Susan R.

In: Neurology, Vol. 81, No. 2, 09.07.2013, p. 119-125.

Research output: Contribution to journalArticle

Thacker, EL, McKnight, B, Psaty, BM, Longstreth, WT, Sitlani, CM, Dublin, S, Arnold, AM, Fitzpatrick, AL, Gottesman, RF & Heckbert, SR 2013, 'Atrial fibrillation and cognitive decline', Neurology, vol. 81, no. 2, pp. 119-125. https://doi.org/10.1212/WNL.0b013e31829a33d1
Thacker EL, McKnight B, Psaty BM, Longstreth WT, Sitlani CM, Dublin S et al. Atrial fibrillation and cognitive decline. Neurology. 2013 Jul 9;81(2):119-125. https://doi.org/10.1212/WNL.0b013e31829a33d1
Thacker, Evan L. ; McKnight, Barbara ; Psaty, Bruce M. ; Longstreth, W. T. ; Sitlani, Colleen M. ; Dublin, Sascha ; Arnold, Alice M. ; Fitzpatrick, Annette L. ; Gottesman, Rebecca F ; Heckbert, Susan R. / Atrial fibrillation and cognitive decline. In: Neurology. 2013 ; Vol. 81, No. 2. pp. 119-125.
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