Earlier onset of atrial fibrillation linked to risk of developing all-cause dementia

Earlier onset of atrial fibrillation (AF) is associated with increased risk of developing all-cause dementia, vascular dementia (VD), and Alzheimer disease (AD), according to a study published online Nov. 8 in JAMA Network Open.

Wenya Zhang, from the Chinese Academy of Medical Sciences & Peking Union Medical College in Beijing, and colleagues conducted a population-based cohort study using data from the U.K. Biobank to examine whether age at AF diagnosis is associated with risk of incident dementia and its subtypes. The main analysis included 433,746 participants.

The researchers found that compared to individuals without AF, the 30,601 with AF had increased risk of developing all-cause dementia and VD (adjusted hazard ratios, 1.42 and 2.06, respectively), but not AD. Younger age at AF onset was associated with increased risks of developing all-cause dementia, AD, and VD (adjusted hazard ratio per 10-year decrease, 1.23, 1.27, and 1.35, respectively).

For developing all-cause dementia, the highest hazard ratio was seen for individuals with AF diagnosed before age 65 years, followed by AF diagnosed at age 65 to 74 years (adjusted hazard ratios, 1.82 and 1.47, respectively) after propensity-score matching; the hazard ratio for AF diagnosed at ≥75 years was not significant. Results were similar for AD and VD.

"The quantitative manifestation of the association between AF onset age and incident dementia highlights the importance of monitoring cognitive function among AF patients, especially those younger than 65 years at diagnosis," the authors write.

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