10
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      The association of atrial fibrillation and dementia incidence: a meta-analysis of prospective cohort studies

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Objectives

          To assess and synthesize the prospective cohort studies published so far on the association between atrial fibrillation (AF) and dementia incidence.

          Methods

          We searched PubMed, Web of Science, and the Cochrane Library for potential studies published in English previous to April 2018. Two independent reviewers screened the search results for prospective cohort studies reporting the association between AF and dementia incidence in patients with normal cognitive function at baseline and not suffering from an acute stroke. The Newcastle-Ottawa Scale was adopted to evaluate the quality of the included studies. The pooled hazard ratio (HR) of AF for dementia was calculated with the Comprehensive Meta-Analysis software, version 2. Heterogeneity and publication bias were assessed with the I 2 test and funnel plot, respectively.

          Results

          We finally identified 11 prospective cohort studies covering 112,876 patients. All the included studies reported an adjusted HR obtained in multiple Cox regression models. The qualities of the included studies ranged from moderate to high. In pooled analysis with a fixed-effects model, AF was independently associated with dementia incidence (HR = 1.34, 95% CI: 1.24–1.44). Subgroup analysis of studies considering anticoagulation as an important confounding factor achieved a similar result. Based on the I 2 test and funnel plot, we did not detect obvious heterogeneity and publication bias in our study. Meta-regression on age did not find significant results.

          Conclusions

          The results of our meta-analysis further confirmed that AF was an independent risk factor for dementia in patients with normal baseline cognitive function not suffering from acute stroke. Screening for dementia in AF patients and including dementia as an independent outcome in large AF treatment trials is warranted.

          Related collections

          Most cited references28

          • Record: found
          • Abstract: found
          • Article: not found

          Diabetes mellitus and risk of dementia: A meta‐analysis of prospective observational studies

          Abstract Aims/Introduction The aim of the present study was to investigate the association between diabetes and the risk of all type dementia (ATD), Alzheimer's disease (AD) and vascular dementia (VaD). Materials and Methods Prospective observational studies describing the incidence of ATD, AD and VaD in patients with diabetes mellitus were extracted from PubMed, EMBASE and other databases up to January 2012. Pooled relative risk (RR) estimates and 95% confidence intervals (CIs) were calculated using the random‐effects model. Subgroup analyses and sensitivity analysis were also carried out. Results A total of 28 studies contributed to the analysis. Pooled RR of developing ATD (n = 20) was 1.73 (1.65–1.82, I 2 = 71.2%), AD (n = 20) was 1.56 (1.41–1.73, I 2 = 9.8%) and VaD (n = 13) was 2.27 (1.94–2.66, I 2 = 0%) in patients with diabetes mellitus. Higher and medium quality studies did not show any significant difference for pooled RR for ATD, AD or VaD. Sensitivity analyses showed robustness of pooled RR among ATD, AD and VaD, showing no single study had a major impact on pooled RR. Conclusions The results showed a 73% increased risk of ATD, 56% increase of AD and 127% increase of VaD in diabetes patients.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Atrial fibrillation and dementia in a population-based study. The Rotterdam Study.

            Atrial fibrillation is a frequent disorder in the elderly and a known risk factor for cerebrovascular stroke. We investigated the association of atrial fibrillation with dementia and cognitive impairment in a large cross-sectional, population-based study in the elderly. Of the 6584 participants in the Rotterdam Study aged 55 to 106 years, detailed information on dementia status and ECG abnormalities was available. Dementia was diagnosed in three phases. First, participants were screened. Screen-positive subjects were tested further. Those with possible dementia underwent an extensive diagnostic workup. Dementia and dementia subtypes were diagnosed according to prevailing criteria. Cognitive impairment was defined as a Mini-Mental State Examination test score of < 26 points for a nondemented subject. Atrial fibrillation was diagnosed in 195, dementia in 276, and cognitive impairment in 635 subjects. We found significant positive associations of atrial fibrillation with both dementia and impaired cognitive function (age- and sex-adjusted odds ratios, 2.3 [95% confidence interval, 1.4 to 3.7] and 1.7 [95% confidence interval, 1.2 to 2.5]), respectively). The strongest association was found not for vascular dementia but rather for Alzheimer's disease with cerebrovascular disease. The associations were stronger in women, and the relation with dementia was more pronounced in the relatively younger elderly. A history of stroke in subjects with atrial fibrillation could not account for these associations. Dementia and subtypes Alzheimer's disease and vascular dementia may be related to atrial fibrillation even if no clinical stokes have occurred.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Heart diseases and long-term risk of dementia and Alzheimer's disease: a population-based CAIDE study.

              Many cardiovascular risk factors are shown to increase the risk of dementia and Alzheimer's disease (AD), but the impact of heart disease on later development of dementia is still unclear.
                Bookmark

                Author and article information

                Journal
                J Geriatr Cardiol
                J Geriatr Cardiol
                JGC
                Journal of Geriatric Cardiology : JGC
                Science Press
                1671-5411
                March 2019
                : 16
                : 3
                : 298-306
                Affiliations
                [1 ]Department of Neurology, Xijing Hospital, the Fourth Military Medical University, Xi'an, Shaanxi, China
                [2 ]Department of Geriatrics, Xijing Hospital, the Fourth Military Medical University, Xi'an, Shaanxi, China
                Author notes
                Correspondence to: Zhi-Rong LIU, Department of Neurology, Xijing Hospital, No.127, West Changle Road, Xi'an, Shaanxi, China. E-mail: liuzhir@ 123456fmmu.edu.cn
                Article
                jgc-16-03-298
                10.11909/j.issn.1671-5411.2019.03.006
                6500564
                31080473
                5481ba07-59ac-4b14-9636-42eb6f7e2e81
                Institute of Geriatric Cardiology

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License, which allows readers to alter, transform, or build upon the article and then distribute the resulting work under the same or similar license to this one. The work must be attributed back to the original author and commercial use is not permitted without specific permission.

                History
                : 1 January 2019
                : 10 March 2019
                : 10 March 2019
                Categories
                Research Article

                Cardiovascular Medicine
                atrial fibrillation,arrhythmias,cognitive impairment,dementia,meta-analysis

                Comments

                Comment on this article