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European Heart Journal Advance Access published online on April 25, 2007
European Heart Journal, doi:10.1093/eurheartj/ehm012
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Risk of dementia in stroke-free patients diagnosed with atrial fibrillation: data from a community-based cohort

Yoko Miyasaka1,4, Marion E. Barnes1, Ronald C. Petersen2, Stephen S. Cha3, Kent R. Bailey3, Bernard J. Gersh1, Grace Casaclang-Verzosa1, Walter P. Abhayaratna1, James B. Seward1, Toshiji Iwasaka4 and Teresa S.M. Tsang1,*

1 Division of Cardiovascular Disease and Internal Medicine, Mayo Clinic, 200 First Street, SW., Rochester, MN 55905, USA
2 Division of Neurology, Mayo Clinic, Rochester, MN, USA
3 Section of Biostatistics, Mayo Clinic, Rochester, MN, USA
4 Cardiovascular Division, Department of Medicine II, Kansai Medical University, Osaka, Japan

Received 15 June 2006; revised 30 January 2007; accepted 15 February 2007.

* Corresponding author. Tel: +1 507 266 4130; fax: +1 507 284 3968. E-mail address: tsang.teresa{at}mayo.edu

Aims: To estimate the incidence of dementia after the first atrial fibrillation (AF), and its impact on survival in a community-based cohort.

Methods and results: Olmsted County, Minnesota adult residents diagnosed with first AF during 1986–2000 were identified, and followed until 2004. The primary outcome was new detection of dementia. Interim stroke was censored in the analyses. Of 2837 subjects (71 ± 15 years old) diagnosed with first AF and without any evidence of cognitive dysfunction or stroke at the time of AF onset, 299 were diagnosed with dementia during a median follow-up of 4.6 years [interquartile (IQR) range 1.5–7.9 years], and 1638 died. The Kaplan–Meier cumulative rate of dementia was 2.7% at 1 year and 10.5% at 5 years. After adjustment for age and sex, dementia was strongly related to advancing age [hazard ratio (HR)/10 years, 2.8; 95% confidence interval (CI), 2.5–3.2], but did not vary with sex (P = 0.52). The occurrence of post-AF dementia was associated with significantly increased mortality risk (HR 2.9; 95% CI 2.5–3.3), even after adjustment for multiple comorbidities, and did not vary with age (P = 0.75) or sex (P = 0.33).

Conclusion: Dementia appeared common following the diagnosis of first AF, and was associated with premature death.

Key Words: Atrial fibrillation • Dementia • Incidence • Prognosis

This paper was guest edited by R. Whitmer


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