Atrial fibrillation ups risk of dementia in seniors

The risk of developing dementia in older adults appears to be elevated in the presence of atrial fibrillation (AF), with some indication of a risk increase already at age <65 years, according to a study.

Researchers conducted a systematic review and meta-analysis of studies reporting on the association between AF and dementia among individuals aged <70 years. They searched multiple online databases and retrieved 1,006 potentially eligible studies. Of these, six studies were included in the meta-analysis.

All of the included studies had a cohort design and comprised about 1.6 million participants with a mean age at recruitment ranging 42–85 years. A total of 3,647 adults aged <70 years overall developed dementia over the follow‐up, which ranged between 1 month and 8 years.

Dementia diagnosis was established using medical records, prescriptions of disease‐specific medications (eg, donepezil and rivastigmine), clinical neuroimaging, hospital discharge records, diagnosis confirmation at least twice in outpatient clinic, and use of neuropsychological/cognitive tests (eg, the Mini‐Mental State Examination and the Geriatric Mental State Schedule).

Pooled data showed that AF was an independent risk factor for early-onset dementia (summary risk ratio [RR], 1.50, 95 percent confidence interval [CI], 1.00–2.26). When analysis was restricted using stroke‐censored results or excluded vascular dementia, results showed a similarly increased AF‐related risk of early-onset dementia (summary RR, 1.38, 95 percent CI, 0.91–2.11).

Age‐stratified analyses showed greater risk increase among individuals with increasing age ranges (age group <65 years: summary RR, 1.06, 95 percent CI, 0.54–2.06; age group <67 years: summary RR, 1.81, 95 percent CI, 1.11–2.95; age group <70 years: summary RR, 2.13, 95 percent CI, 1.58–2.87).

More studies are required to identify which characteristics of the arrhythmia and which mechanisms play a role in the association between AF and dementia.