Correlates of Dementia and Mild Cognitive Impairment in Patients With Atrial Fibrillation: the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS)

Background: atrial fibrillation (af) has been associated with faster cognitive decline and increased dementia risk. factors associated with dementia in patients with af have been seldom studied.methods and results: we studied 6432 individuals from the aric-ncs (atherosclerosis risk in communities neurocognitive study). in 2011 to 2013,participants underwent a physical exam,echocardiography,detailed cognitive assessments,and a subset,brain magnetic resonance imaging. dementia and mild cognitive impairment (mci),as well as etiology of mci/dementia,alzheimer's disease-related or vascular,were adjudicated by an expert panel. af was defined by study ecgs and past hospitalizations. we used logistic regression to estimate odds ratios and 95% ci of mci/dementia by af status and to assess cross-sectional correlates of mci/dementia in patients with af. among 6432 participants,611 (9.5%) had prevalent af. af was associated with increased odds of dementia and mci (odds ratio,95% ci,2.25,1.64-3.10,and 1.28,1.04-1.56,respectively). prevalence of alzheimer's disease-related mci/dementia and vascular mci/dementia were higher in participants with af than without af (odds ratio,95% ci,1.29,1.04-1.61,and 1.50,0.99-2.25,respectively). in multivariable analyses,older age,lower body mass index,diabetes mellitus,stroke,and apoe genotype were associated with dementia prevalence in participants with af. in models evaluating mci/dementia subtypes,diabetes mellitus was associated with alzheimer's disease-related mci/dementia,whereas male sex and stroke were risk factors for vascular mci/dementia.conclusions: in a large,community-based study,af was associated with higher prevalence of mci and dementia. controlling cardiometabolic risk factors is a potential target for prevention of adverse cognitive outcomes in af patients. © 2017 the authors. published on behalf of the american heart association,inc.,by wiley.