New findings suggest incident atrial fibrillation (AF) is linked with a 50 per cent increased risk of dementia in an older population, even in those who have not had a stroke. However, AF patients who took oral anti-coagulants had a decreased risk.
Researchers examined data on 262,611 people aged 60 years or above from the Korea National Health Insurance Service Senior cohort who were free from AF and dementia at enrolment from 2005 and 2012 and were followed until 2013.
Incident AF was observed in 10,435 participants. After adjustment, the risk of dementia was significantly increased by incident AF (Hazard ratio [HR] 1.52; 95% CI 1.43-1.63), even after censoring for stroke (HR 1.27; 95% CI 1.18-1.37). The study also found incident AF increased the risk of both Alzheimer's disease (HR 1.31) and vascular dementia (HR 2.11). Increasing CHA2DS2-VASc score was associated with a higher risk of dementia.
Among those with incident AF, oral anti-coagulant use was associated with a preventive effect on dementia development (HR 0.61).
“Based on the findings of the present study, physicians should be vigilant for clinical manifestations implying any cognitive decline and functional impairment in AF patients, especially those with a high CHA2DS2-VASc score,” the authors said.