Chen Yung-Lung, Chen Joseph, Wang Hui-Ting, Chang Ya-Ting, Chong Shaur-Zheng, Hsueh Shukai, Chung Chang-Ming, Lin Yu-Sheng
Division of Cardiology and Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan.
Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan.
Diagnostics (Basel). 2021 Apr 23;11(5):760. doi: 10.3390/diagnostics11050760.
Atrial fibrillation (AF) is one of the risk factors for dementia. Female sex is an inconsistent risk factor for dementia after adjusting for age in the general population, and there lacks research on its impact in developing dementia in patients with AF. This paper aims to investigate whether female sex is a risk factor for dementia in AF patients. Data of patients with newly diagnosed AF between 2001-2013 were retrieved from Taiwan's National Health Insurance Research Database. Exclusion criteria were: patients with incomplete demographic data, age < 20 years, rheumatic heart disease, hyperthyroidism, past valvular heart surgery, and a history of dementia. Propensity score matching (PSM) between sexes was performed, including comorbidities, medications and index date stratified by age. The primary outcome was a new diagnosis of dementia at follow-up. A total of 117,517 men and 156,705 women were eligible for analysis. After 1:1 PSM, both 100,065 men and women (aged 72.5 ± 12.5 years) were included for analysis. Dementia risk varied with age in women compared with men. The difference was negligible for ≤55 years (sub distribution HR (SHR) = 0.89, 95% CI 0.73-1.07), but increased between 56-65 years (SHR = 1.13, 95% CI 1.02-1.25), 66-75 years (SHR = 1.14, 95% CI 1.09-1.20), 75-85 years (SHR = 1.11, 95% CI 1.07-1.15) and >85 years (SHR 1.10, 95% CI 1.04-1.16) for females. This study establishes that female sex increases the risk of developing dementia compared to male sex in AF patients aged >56 years. However, the impact of female sex on dementia in AF patients differs between dementia types.
心房颤动（AF）是痴呆症的风险因素之一。在一般人群中，调整年龄后，女性是痴呆症的一个不一致的风险因素，并且缺乏关于其对房颤患者患痴呆症影响的研究。本文旨在调查女性是否是房颤患者患痴呆症的风险因素。从台湾国民健康保险研究数据库中检索了2001年至2013年间新诊断为房颤的患者数据。排除标准为：人口统计学数据不完整的患者、年龄<20岁、风湿性心脏病、甲状腺功能亢进、既往瓣膜心脏手术以及痴呆症病史。对性别进行倾向得分匹配（PSM），包括按年龄分层的合并症、药物和索引日期。主要结局是随访时新诊断的痴呆症。共有117,517名男性和156,705名女性符合分析条件。经过1:1的PSM后，纳入100,065名男性和女性（年龄72.5±12.5岁）进行分析。与男性相比，女性患痴呆症的风险随年龄而异。≤55岁时差异可忽略不计（亚分布风险比（SHR）=0.89，95%置信区间0.73-1.07），但在56-65岁（SHR=1.13，95%置信区间1.02-1.25）、66-75岁（SHR=1.14，95%置信区间1.09-1.20）、75-85岁（SHR=1.11，95%置信区间1.07-1.15）和>85岁（SHR 1.10，95%置信区间1.04-1.16）时女性风险增加。本研究证实，在年龄>56岁的房颤患者中，女性比男性患痴呆症的风险更高。然而，女性性别对房颤患者痴呆症的影响在不同痴呆类型之间存在差异。
