The Irish Longitudinal Study on Ageing, Trinity College, Dublin, Ireland.
Department of Medical Gerontology, Trinity College, Dublin, Ireland.
Age Ageing. 2021 Nov 10;50(6):2192-2198. doi: 10.1093/ageing/afab141.
Atrial fibrillation (AF) has been proposed as a risk factor for cognitive impairment, even in the absence of a history of stroke. This study investigates whether AF is associated with increased risk of cognitive decline in a community-dwelling population of adults over the age of 50.
Data from the 1st and 3rd waves of The Irish Longitudinal Study on Ageing (TILDA) were used (4-year follow-up period). TILDA is a large prospective cohort study of community-dwelling adults over the age of 50 in Ireland. AF was assessed via electrocardiogram. Global cognitive function was assessed at baseline and follow-up using Montreal Cognitive Assessment (MOCA). Analysis of global cognition was repeated stratifying by age. Mixed-effects Poisson regression was used to assess for change in rate of errors on MOCA and MOCA subdomains.
A total of 3,417 participants were included in the study. Results found that participants with AF had a greater increase in rate of errors on MOCA over 4-year follow-up (incident rate ratio (IRR) 1.18; 95% confidence interval (CI) 1.02, 1.37; P-value 0.023). However, this was no longer significant on controlling for age, sex and level of education (IRR 1.08; 95% CI 0.93, 1.25; P-value 0.332). There was no difference when stratifying by age group, or when separating MOCA into subdomains.
Individuals with AF were more likely to show an increase in rate of errors between waves 1 and 3 (4-year follow-up period) in the TILDA population; however, results were not significant when controlling for age, sex and level of education.
心房颤动(AF)已被提出是认知障碍的一个风险因素,即使在没有中风病史的情况下也是如此。本研究调查了在年龄超过 50 岁的社区居住成年人中,AF 是否与认知能力下降的风险增加有关。
使用了爱尔兰老龄化纵向研究(TILDA)的第 1 波和第 3 波的数据(4 年随访期)。TILDA 是一项针对爱尔兰 50 岁以上社区居住成年人的大型前瞻性队列研究。通过心电图评估 AF。在基线和随访时使用蒙特利尔认知评估(MOCA)评估整体认知功能。通过年龄分层分析对整体认知进行了重复分析。使用混合效应泊松回归评估 MOCA 和 MOCA 子域上错误率的变化。
共有 3417 名参与者纳入研究。结果发现,AF 患者在 4 年随访期间 MOCA 错误率增加更多(发病率比(IRR)1.18;95%置信区间(CI)1.02,1.37;P 值 0.023)。然而,在控制年龄、性别和教育水平后,这不再具有统计学意义(IRR 1.08;95%CI 0.93,1.25;P 值 0.332)。在按年龄组分层或将 MOCA 分为子域时,没有差异。
在 TILDA 人群中,AF 患者在第 1 波和第 3 波(4 年随访期)之间错误率增加的可能性更大;然而,在控制年龄、性别和教育水平后,结果没有统计学意义。