UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

The association between atrial fibrillation and dementia: A UK linked electronic health records cohort study

Brooks, Kieran; Yoshimura, Hiroyuki; Gonzalez-Izquierdo, Arturo; Zakkak, Nadine; Kukendra-Rajah, Kishore; Lip, Gregory YH; Providencia, Rui; (2024) The association between atrial fibrillation and dementia: A UK linked electronic health records cohort study. European Journal of Clinical Investigation , Article e14154. 10.1111/eci.14154. (In press). Green open access

[thumbnail of providencia-et-al-2023-cognitive-impairment-and-dementia-in-atrial-fibrillation.pdf]
Preview
PDF
providencia-et-al-2023-cognitive-impairment-and-dementia-in-atrial-fibrillation.pdf - Published Version

Download (425kB) | Preview

Abstract

BACKGROUND: We investigated the association between atrial fibrillation (AF) and dementia, and its subtypes (vascular-VaD, Alzheimer, mixed and rare dementia), and identified predictors for dementia in AF patients. METHODS: The analysis was based on 183,610 patients with new-onset AF and 367,220 non-AF controls in the United Kingdom between 1998 and 2016, identified in three prospectively collected, linked electronic health records sources. Time-to-event (dementia or subtypes) analyses were performed using Cox proportional hazards and weighted Cox. Sub-analyses performed: including & censoring stroke and age (median used as cut-off). RESULTS: Over a median follow-up of 2.67 years (IQR .65-6.02) for AF patients and 5.84 years for non-AF patients (IQR 2.26-11.80), incidence of dementia in the AF cohort was 2.65 per 100 person-years, compared to 2.02 in the non-AF cohort. After adjustment, a significant association was observed between AF and all-cause dementia (HR = 1.38, 95% CI: 1.31-1.45), driven by a strong association with VaD (HR = 1.55, 95% CI: 1.41-1.70). AF was also associated with mixed dementia (HR = 1.26, 95% CI: 1.01-1.56), but we could not confirm an association with Alzheimer (HR = 1.05, 95% CI: .94-1.16) and rare dementia forms (HR = 1.19, 95% CI: .90-1.56). Ischemic stroke (HR = 1.40, 95% CI: 1.26-1.56), subarachnoid haemorrhage (HR = 2.08, 95% CI: 1.47-2.96), intracerebral haemorrhage (HR = 1.95, 95% CI: 1.54-2.48) and diabetes (HR = 1.32, 95% CI: 1.24-1.41) were identified as the strongest predictors of dementia in AF patients. CONCLUSIONS: AF patients have an increased risk of dementia, independent of stroke, with highest risk of VaD. Management and prevention of the identified risk factors could be crucial to reduce the increasing burden of dementia.

Type: Article
Title: The association between atrial fibrillation and dementia: A UK linked electronic health records cohort study
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/eci.14154
Publisher version: https://doi.org/10.1111/eci.14154
Language: English
Additional information: © 2024 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/).
Keywords: Alzheimer's, arrhythmia, caliber, CPRD, HDRUK, prognosis, vascular
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics
URI: https://discovery.ucl.ac.uk/id/eprint/10185458
Downloads since deposit
0Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item