Healthy lifestyle behaviours protect against dementia in AF patients

Patients with new-onset atrial fibrillation (AF) who practice a healthy lifestyle appear to be at lower risk of dementia, a study has shown.

The study used data from the Korean National Health Insurance database and included 199,952 adult patients (mean age 63.2 years, 60.2 percent male) who were newly diagnosed with AF. They were grouped according to their healthy lifestyle behaviour score (HLS), with 1 point each assigned for no current smoking, alcohol abstinence, and regular exercise.

More than half (53.4 percent) of the patients had HLS 2, 24.8 percent had HLS 3, 17.4 percent had HLS 1, and 4.4 percent had HLS 0. Compared with the HLS 3 group, the HLS 0 group—where patients had a cluster of three unhealthy lifestyle behaviours—was more likely to be younger, men, have lower CHA₂DS₂‐VASc scores, and lower prevalence of comorbidities.

Over a median follow-up of 3.4 years, dementia occurred in 327, 1,425, 7,625, and 2,444 patients in the HLS 0, 1, 2, and 3 groups, respectively. The corresponding weighted incidence rates of dementia were 21.8, 16.8, 16.8, and 13.6 per 1,000 person‐years.

A weighted Cox proportional hazards regression model showed the risk of developing dementia relative to the HLS group 0 was lower across HLS 1 (hazard ratio [HR], 0.769, 95 percent confidence interval [CI], 0.704–0.842), HLS 2 (HR, 0.770, 95 percent CI, 0.709–0.836), and HLS 3 groups (HR, 0.622, 95 percent CI, 0.569–0.679).

Of note, the risk of dementia tended to decrease as the cluster of healthy lifestyle behaviours increased (p_trend<0.001).

The present data support the promotion of a healthy lifestyle within an integrated care approach to AF patient management.