Atrial fibrillation and cognitive decline-the role of subclinical cerebral infarcts: the atherosclerosis risk in communities study

Chen, Lin Y., Lopez, Faye L., Gottesman, Rebecca F., Huxley, Rachel R., Agarwal, Sunil K., Loehr, Laura, Mosley, Thomas and Alonso, Alvaro (2014) Atrial fibrillation and cognitive decline-the role of subclinical cerebral infarcts: the atherosclerosis risk in communities study. Stroke, 45 9: 2568-2574+. doi:10.1161/STROKEAHA.114.005243


Author Chen, Lin Y.
Lopez, Faye L.
Gottesman, Rebecca F.
Huxley, Rachel R.
Agarwal, Sunil K.
Loehr, Laura
Mosley, Thomas
Alonso, Alvaro
Title Atrial fibrillation and cognitive decline-the role of subclinical cerebral infarcts: the atherosclerosis risk in communities study
Journal name Stroke   Check publisher's open access policy
ISSN 0039-2499
1524-4628
Publication date 2014-09
Year available 2014
Sub-type Article (original research)
DOI 10.1161/STROKEAHA.114.005243
Open Access Status
Volume 45
Issue 9
Start page 2568
End page 2574+
Total pages 17
Place of publication Philadelphia PA, United States
Publisher Lippincott Williams & Wilkins
Collection year 2015
Language eng
Formatted abstract
Background and Purpose—The mechanism underlying the association of atrial fibrillation (AF) with cognitive decline in stroke-free individuals is unclear. We examined the association of incident AF with cognitive decline in stroke-free individuals, stratified by subclinical cerebral infarcts (SCIs) on brain MRI scans.

Methods—We analyzed data from 935 stroke-free participants (mean age±SD, 61.5±4.3 years; 62% women; and 51% black) from 1993 to 1995 through 2004 to 2006 in the Atherosclerosis Risk in Communities Study, a biracial community-based prospective cohort study. Cognitive testing (including the digit symbol substitution and the word fluency tests) was performed in 1993 to 1995, 1996 to 1998, and 2004 to 2006 and brain MRI scans in 1993 to 1995 and 2004 to 2006.

Results—During follow-up, there were 48 incident AF events. Incident AF was associated with greater annual average rate of decline in digit symbol substitution (−0.77; 95% confidence interval, −1.55 to 0.01; P=0.054) and word fluency (−0.80; 95% confidence interval, −1.60 to −0.01; P=0.048). Among participants without SCIs on brain MRI scans, incident AF was not associated with cognitive decline. In contrast, incident AF was associated with greater annual average rate of decline in word fluency (−2.65; 95% confidence interval, −4.26 to −1.03; P=0.002) among participants with prevalent SCIs in 1993 to 1995. Among participants who developed SCIs during follow-up, incident AF was associated with a greater annual average rate of decline in digit symbol substitution (−1.51; 95% confidence interval, −3.02 to −0.01; P=0.049).

Conclusions—The association of incident AF with cognitive decline in stroke-free individuals can be explained by the presence or development of SCIs, raising the possibility of anticoagulation as a strategy to prevent cognitive decline in AF.
Keyword Atrial fibrillation
Cognition
Epidemiology
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Public Health Publications
 
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