Clinical Research Unit, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.
Department of Medical Service, Naval Hospital of Eastern theater, Zhoushan, Zhejiang 316000, China; Department of Health Statistics, Naval Medical University, Shanghai 200433, China.
J Affect Disord. 2024 Apr 15;351:323-330. doi: 10.1016/j.jad.2024.01.224. Epub 2024 Jan 28.
Accumulated evidence has highlighted the association between atrial fibrillation and the risk of developing dementia.
This current cohort study utilized data from the UK Biobank to explore the association between atrial fibrillation (AF) and all-cause dementia (ACD), encompassing its main subtypes (Alzheimer's disease (AD), and vascular dementia (VD)). Cox proportional hazards models were applied to examine the association of AF and dementia with its primary subtypes after adjusting for different sets of covariates. Hazard ratios (HRs) with 95 % confidential intervals (CIs) were estimated to quantify the associated risks. Competing risk model was applied in sensitivity analysis.
After exclusion, 373, 415 participants entered the primary analysis. Among these, 27, 934 (7.48 %) were with a history AF at baseline, while 345, 481 (92.52 %) were without. During a mean follow-up of 13.45 years, ACD was diagnosed in 1215 individuals with AF and 3988 individuals without AF. Participants with AF had higher risks of ACD (1.79 [1.67-1.91]), AD (1.48 [1.32-1.65]), and VD (2.46 [2.17-2.80]) in the fully adjusted Cox regression models. Results of subgroup and sensitivity analyses predominantly aligned with the positive associations in primary analysis.
The applicability of our findings to diverse ethnicities might require careful consideration and the behind biological mechanisms need to be further revealed.
It indicated that people with atrial fibrillation had an increased future risk of all-cause dementia, Alzheimer's disease, vascular dementia. Atrial fibrillation screening and prevention strategies should take into account to prevent and delay the onset of dementia.
越来越多的证据表明心房颤动与痴呆风险之间存在关联。
本队列研究利用英国生物库的数据,探讨了心房颤动(AF)与全因痴呆(ACD)的关系,包括其主要亚型(阿尔茨海默病(AD)和血管性痴呆(VD))。应用 Cox 比例风险模型,在调整了不同的协变量集后,检查了 AF 和痴呆症及其主要亚型之间的关联。风险比(HRs)及其 95%置信区间(CIs)用于量化相关风险。竞争风险模型用于敏感性分析。
排除后,373 名、415 名参与者进入主要分析。其中,27 名、934 名(7.48%)在基线时患有 AF,345 名、481 名(92.52%)无 AF。在平均 13.45 年的随访期间,1215 名有 AF 的参与者和 3988 名无 AF 的参与者被诊断为 ACD。在完全调整的 Cox 回归模型中,有 AF 的参与者发生 ACD(1.79 [1.67-1.91])、AD(1.48 [1.32-1.65])和 VD(2.46 [2.17-2.80])的风险更高。亚组和敏感性分析的结果主要与主要分析中的阳性关联一致。
我们的研究结果对不同种族的适用性可能需要谨慎考虑,背后的生物学机制需要进一步揭示。
这表明患有心房颤动的人未来发生全因痴呆、阿尔茨海默病、血管性痴呆的风险增加。心房颤动的筛查和预防策略应考虑在内,以预防和延缓痴呆的发生。