Association Between Relevant Co-Morbidities and Dementia With Atrial Fibrillation-A National Study.
Aged
Aged, 80 and over
Antihypertensive Agents
/ therapeutic use
Atrial Fibrillation
/ complications
Cerebrovascular Disorders
/ complications
Comorbidity
Coronary Disease
Dementia
/ complications
Depression
/ epidemiology
Diabetes Mellitus
/ epidemiology
Female
Heart Failure
/ epidemiology
Humans
Hypertension
/ drug therapy
Male
Middle Aged
Primary Health Care
Risk Factors
Stroke
/ epidemiology
Sweden
Atrial fibrillation
Dementia
Depression
Gender
Hypertension
Stroke
Journal
Archives of medical research
ISSN: 1873-5487
Titre abrégé: Arch Med Res
Pays: United States
ID NLM: 9312706
Informations de publication
Date de publication:
02 2019
02 2019
Historique:
received:
14
03
2019
revised:
06
05
2019
accepted:
20
05
2019
entrez:
28
7
2019
pubmed:
28
7
2019
medline:
27
2
2020
Statut:
ppublish
Résumé
The risk of dementia is increased in patients with atrial fibrillation (AF). To study relevant co-morbidities and incident dementia (vascular dementia, Alzheimers disease, other dementia and all dementia) in AF patients. 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. 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. 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.
Sections du résumé
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.
Identifiants
pubmed: 31349951
pii: S0188-4409(19)30300-5
doi: 10.1016/j.arcmed.2019.05.007
pmc: PMC6712561
mid: NIHMS1536766
pii:
doi:
Substances chimiques
Antihypertensive Agents
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
29-35Subventions
Organisme : NHLBI NIH HHS
ID : R01 HL116381
Pays : United States
Informations de copyright
Copyright © 2019 IMSS. Published by Elsevier Inc. All rights reserved.
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