Association Between Relevant Co-Morbidities and Dementia in Patients With Atrial Fibrillation–A National Swedish Study

TY - JOUR

T1 - Association Between Relevant Co-Morbidities and Dementia in Patients With Atrial Fibrillation–A National Swedish Study

AU - Wändell, Per

AU - Carlsson, Axel C.

AU - Li, Xinjun

AU - Sundquist, Jan

AU - Sundquist, Kristina

PY - 2019

Y1 - 2019

N2 - Background: The risk of dementia is increased in patients with atrial fibrillation (AF). Objective: To study relevant co-morbidities and incident dementia (vascular dementia, Alzheimers disease, other dementia and all dementia) in AF patients. Methods: All adults (n = 537,513) ≥45 years diagnosed with AF in hospitals in Sweden 1998–2012 were included. Cox regression was used to estimate hazard ratios (HR) with 95% CIs for association between co-morbidities, and incident dementia, after adjustment for age, residence place in Sweden, and socio-economic factors. Results: Totally 30,332 patients (5.6%) were diagnosed with dementia during the follow-up, with 14,097 men (4.9%) and 16,235 women (6.5%). After adjustments (HRs; 95% CI), hypertension was associated with lower risk of incident dementia (all types) in men (0.79; 0.76–0.82) and women (0.77; 0.74–0.79). Higher risk of dementia was seen in patients with stroke, diabetes, depression and anxiety. Lower risks of dementia were also seen in AF patients with concomitant coronary heart disease and congestive heart failure. Conclusions: The findings regarding incident dementia need to be interpreted with great caution, owing to possible “survival bias” or reversed causation. However, the lower associated risks of dementia associated with hypertension could possibly be explained by protective effects of certain antihypertensive drugs.

AB - Background: The risk of dementia is increased in patients with atrial fibrillation (AF). Objective: To study relevant co-morbidities and incident dementia (vascular dementia, Alzheimers disease, other dementia and all dementia) in AF patients. Methods: All adults (n = 537,513) ≥45 years diagnosed with AF in hospitals in Sweden 1998–2012 were included. Cox regression was used to estimate hazard ratios (HR) with 95% CIs for association between co-morbidities, and incident dementia, after adjustment for age, residence place in Sweden, and socio-economic factors. Results: Totally 30,332 patients (5.6%) were diagnosed with dementia during the follow-up, with 14,097 men (4.9%) and 16,235 women (6.5%). After adjustments (HRs; 95% CI), hypertension was associated with lower risk of incident dementia (all types) in men (0.79; 0.76–0.82) and women (0.77; 0.74–0.79). Higher risk of dementia was seen in patients with stroke, diabetes, depression and anxiety. Lower risks of dementia were also seen in AF patients with concomitant coronary heart disease and congestive heart failure. Conclusions: The findings regarding incident dementia need to be interpreted with great caution, owing to possible “survival bias” or reversed causation. However, the lower associated risks of dementia associated with hypertension could possibly be explained by protective effects of certain antihypertensive drugs.

KW - Atrial fibrillation

KW - Dementia

KW - Depression

KW - Gender

KW - Hypertension

KW - Stroke

U2 - 10.1016/j.arcmed.2019.05.007

DO - 10.1016/j.arcmed.2019.05.007

M3 - Article

C2 - 31349951

AN - SCOPUS:85066334907

VL - 50

SP - 29

EP - 35

JO - Archives of Medical Research

JF - Archives of Medical Research

SN - 0188-4409

IS - 2

ER -