Atrial fibrillation and cognitive decline-the role of subclinical cerebral infarcts: The atherosclerosis risk in communities study
MetadataShow full item record
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 to2006 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.
Showing items related by title, author, creator and subject.
Modelling the co-occurence of Streptococcus pneumoniae with other bacterial and viral pathogens in the upper respiratory tractJacoby, P.; Watson, K.; Bowman, J.; Taylor, A.; Riley, T.; Smith, D.; Lehmann, Deborah (2007)Go to ScienceDirect® Home Skip Main Navigation Links Brought to you by: The University of Western Australia Library Login: + Register Athens/Institution Login Not Registered? - User Name: Password: ...
Higher free thyroxine levels predict increased incidence of dementia in older men: The health in men studyYeap, B.; Alfonso, Helman; Chubb, S.; Puri, G.; Hankey, G.; Flicker, L.; Almeida, O. (2012)Context: Both hypothyroidism and subclinical hyperthyroidism hinder cognitive function. Objective: We aimed to determine whether more subtle alterations of thyroid hormone levels predict increased incidence of dementia ...
Erectile dysfunction and later cardiovascular disease in men with type 2 diabetes: Prospective cohort study based on the ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified-Release Controlled Evaluation) trialBatty, G.; Li, Q.; Czernichow, S.; Neal, B.; Zoungas, S.; Huxley, Rachel; Patel, A.; De Galan, B.; Woodward, M.; Hamet, P.; Harrap, S.; Poulter, N.; Chalmers, J. (2010)Objectives The aim of this study was to examine the relationship between erectile problems in men and cardiovascular disease (CVD) mortality. Background Although there are plausible mechanisms linking erectile dysfunction ...