title: Atrial fibrillation and risk of dementia: a prospective cohort study.
abstract: OBJECTIVE
  To determine whether atrial fibrillation (AF) is associated with risk of incident dementia or Alzheimer's disease (AD), beyond its effect on stroke.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  An integrated healthcare delivery system.
  
  
  METHODS
  A population-based sample of 3,045 community-dwelling adults aged 65 and older without dementia or clinical stroke followed from 1994 to 2008.
  
  
  METHODS
  AF was identified from health plan electronic data using International Classification of Diseases, Ninth Revision, codes from inpatient and outpatient encounters. Covariates came from self-report, study measures, and health plan data. Participants were screened every 2 years using the Cognitive Abilities Screening Instrument (range 0-100), with detailed neuropsychological and clinical assessment of those scoring less than 86. A multidisciplinary consensus committee determined diagnoses of all-cause dementia and possible or probable AD using standard research criteria.
  
  
  RESULTS
  AF was present in 132 (4.3%) participants at baseline and was diagnosed in 370 (12.2%) more over a mean of 6.8 years of follow-up; 572 participants (18.8%) developed dementia (449 with AD). The adjusted hazard ratio associated with AF was 1.38 (95% confidence interval (CI)=1.10-1.73) for all-cause dementia and 1.50 (95% CI=1.16-1.94) for possible or probable AD. Results were similar for participants with and without clinically recognized stroke during follow-up and in sensitivity analyses examining only probable AD.
  
  
  CONCLUSIONS
  AF is associated with higher risk of developing AD and dementia. Future studies should examine whether specific treatments, including optimal anticoagulation, can decrease this risk.
authors.affiliation: Group Health Research Institute, Seattle, Washington, USA. dublin.s@ghc.org
authors.forename: Sascha
authors.initials: S
authors.lastname: Dublin
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Anderson
authors.forename: Sebastien J
authors.initials: SJ
authors.lastname: Haneuse
authors.forename: Susan R
authors.initials: SR
authors.lastname: Heckbert
authors.forename: Paul K
authors.initials: PK
authors.lastname: Crane
authors.forename: John C S
authors.initials: JC
authors.lastname: Breitner
authors.forename: Wayne
authors.initials: W
authors.lastname: McCormick
authors.forename: James D
authors.initials: JD
authors.lastname: Bowen
authors.forename: Linda
authors.initials: L
authors.lastname: Teri
authors.forename: Susan M
authors.initials: SM
authors.lastname: McCurry
authors.forename: Eric B
authors.initials: EB
authors.lastname: Larson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology* / Q000209:etiology*; D001281:Atrial Fibrillation / Q000150:complications* / Q000453:epidemiology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000453:epidemiology; D014861:Washington