Incident atrial fibrillation (AF) is associated with increased risk of mild cognitive impairment (MCI), according to a research letter published online Oct. 25 in JACC: Advances.
Sheng-Chia Chung, Ph.D., from University College London, and colleagues examined the association of AF with MCI and subsequent dementia using U.K. primary electronic health record data. All individuals with incident AF were included; for each case, one randomly selected AF-free individual was selected. Data were included for 233,833 individuals with incident AF and 233,747 individuals without AF.
There were 4,269 total incident MCI cases from both AF and non-AF individuals during a median of 5.3 years of follow-up. The researchers found that the risk of MCI was higher for persons with AF than non-AF, with an adjusted hazard ratio of 1.45. Risk factors such as older age, female sex, higher socioeconomic deprivation, clinical history of depression, stroke, and multimorbidity were associated with a greater risk of MCI, with risk ratios ranging from 1.08 to 1.44. The risk of MCI was not increased for patients with incident AF receiving digoxin treatment. Furthermore, patients receiving oral anticoagulant treatment and amiodarone treatment were not at risk of MCI, while those not receiving oral anticoagulant treatment and amiodarone treatment had higher MCI risk.
“These data provide support to the previous hypothesis of integrated AF care (combining anticoagulation, symptom, and comorbidity-management) as a way of preventing cognitive deterioration and progression to dementia, highlighting the need for a confirmatory clinical trial,”according to Dr. Providencia and colleagues.
