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Association Between Relevant Co-Morbidities and Dementia in Patients With Atrial Fibrillation–A National Swedish Study

Wändell, Per LU ; Carlsson, Axel C.; Li, Xinjun LU ; Sundquist, Jan LU and Sundquist, Kristina LU (2019) In Archives of Medical Research 50(2). p.29-35
Abstract

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),... (More)

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.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Atrial fibrillation, Dementia, Depression, Gender, Hypertension, Stroke
in
Archives of Medical Research
volume
50
issue
2
pages
7 pages
external identifiers
  • scopus:85066334907
ISSN
0188-4409
DOI
10.1016/j.arcmed.2019.05.007
language
English
LU publication?
yes
id
06679433-d432-4a27-9c8a-8d827fbd2e1b
date added to LUP
2019-06-13 10:43:31
date last changed
2019-07-02 04:47:58
@article{06679433-d432-4a27-9c8a-8d827fbd2e1b,
  abstract     = {<p>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.</p>},
  author       = {Wändell, Per and Carlsson, Axel C. and Li, Xinjun and Sundquist, Jan and Sundquist, Kristina},
  issn         = {0188-4409},
  keyword      = {Atrial fibrillation,Dementia,Depression,Gender,Hypertension,Stroke},
  language     = {eng},
  number       = {2},
  pages        = {29--35},
  series       = {Archives of Medical Research},
  title        = {Association Between Relevant Co-Morbidities and Dementia in Patients With Atrial Fibrillation–A National Swedish Study},
  url          = {http://dx.doi.org/10.1016/j.arcmed.2019.05.007},
  volume       = {50},
  year         = {2019},
}