Abstract 12165: Atrial Fibrillation Increases the Risk of Incident Dementia: Evidence From a Meta-Analysis
Introduction. The risk of cerebrovascular embolic events with atrial fibrillation (AF) is potentially linked to an increased risk of cognitive decline and dementia. However, epidemiological studies exploring the association between AF and incident dementia have reported conflicting results. We performed a meta-analysis of observational studies specifically designed to evaluate the prospective relationship between AF and incident dementia.
Methods. Pubmed, CENTRAL and other databases were searched (May 2011). Studies were included if they evaluated the association between AF and the incidence of dementia, providing the hazard ratio (HR) obtained in multiple Cox regression analyses and adjusted for all possible confounders. A random effect inverse variance weighted meta-analysis was performed, by entering the logarithm of the adjusted HR. Data are expressed as HR with 95% confidence interval (CI).
Results. Six studies with 43,117 patients were included in the analysis. All studies were prospective observational studies including elderly patients with normal cognitive function at baseline (mean age range 60 to 80 years), of whom 10,552 (24%) had AF, and only 3.7% had previous history of stroke or transient ischemic attacks. After a mean follow-up of 9.6±11 years (range 4 to 30 years), 2,193/42,106 (5.2%) patients developed dementia, diagnosed according to established criteria (DSM and/or ICD codes). At pooled analysis adjusted for baseline confounders and covariates, AF was independently associated with increased risk of incident dementia (HR = 1.50, 95% CI 1.02 to 2.20, P = 0.038) (Figure).
Conclusions. AF is independently associated with increased risk of dementia, which should be included among the outcomes assessed in AF treatment trials.
- © 2011 by American Heart Association, Inc.