ClinicalAtrial fibrillationAtrial fibrillation is independently associated with senile, vascular, and Alzheimer's dementia
Section snippets
Methods
We examined the Intermountain Heart Collaborative Study database to examine an association of AF and dementia.28 This database includes all patients who receive care within the Intermountain Healthcare system and were seen by cardiologists with consent to participate in research. The population studied as noted in the prior publications is predominantly white (89%), with other races as follows: Hispanic 7%, Polynesian/Asian 1%, black 2%, and Native American 1%. We studied 37,026 consecutive
Results
Of the 37,025 patients with a mean age of 60.6 ± 17.9 years studied, 10,161 (27%) developed AF and 1,535 developed (4.1%) dementia (179 VD, 321 SD, 347 AD, 688 ND) during the 5-year follow-up. The basic demographics of the patient population listed and compared by AF status are shown in Table 1. Patients with AF were older and had higher rates of hypertension, coronary artery disease, renal failure, heart failure, and prior strokes. Statin use was similar between the groups. On average, the
Discussion
AF was independently associated with risk of all forms of dementia. Although dementia is strongly associated with aging, the highest risk of AD was in the younger AF group, in support of the observed association. The presence of AF in all dementia subtypes identified patients at higher risk of mortality. This mortality risk was most prominent in the youngest population studied.
Age remains the strongest risk factor for dementia, particularly for AD.3 In a community-based study, the estimated
Conclusion
AF was independently associated with all forms of dementia. Although dementia is strongly associated with aging, the highest risk of AD was in the younger group, in support of the observed association. The presence of AF also identified dementia patients at high risk of death. These findings require further investigation and confirmation in an effort to understand and prevent dementia as well as to optimally manage dementia patients at higher risk of adverse outcomes.
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Drs. Bunch, Weiss, Crandall, and Osborn have received speaker's honorarium (minor) from Boston Scientific. Dr. Day is a consultant (minor) for Boston Scientific and St. Jude Medical.