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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Relation of Atrial Fibrillation to Cognitive Decline (from the REasons for Geographic and Racial Differences in Stroke [REGARDS] Study)
The American journal of cardiology, v 148, pp 60-68
01 Jun 2021
PMID: 33684372
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The association of atrial fibrillation (AF) with cognitive function remains unclear, espe-cially among racially/geographically diverse populations. This analysis included 25,980 black and white adults, aged 48+, from the national REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort, free from cognitive impairment and stroke at baseline. Baseline AF was identified by self-reported medical history or electrocardiogram (ECG). Cognitive testing was conducted yearly with the Six Item Screener (SIS) to define impairment and at 2-year intervals to assess decline on: animal naming and letter fluency, Montreal Cognitive Assessment (MoCA), Word List Learning (WLL) and Delayed Recall tasks (WLD). Multivariable regression models estimated the relationships between AF and baseline impairment and time to cognitive impairment. Models were adjusted sequen-tially for age, sex, race, geographic region, and education, then cardiovascular risk factors and finally incident stroke. AF was present in 2,168 (8.3%) participants at baseline. AF was associated with poorer baseline performance on measures of: semantic fluency (p<0.01); global cognitive performance (MoCA, p<0.01); and WLD (p<0.01). During a mean follow-up of 8.06 years, steeper declines in list learning were observed among partic-ipants with AF (p<0.03) which remained significant after adjusting for cardiovascular risk factors (p<0.04) and incident stroke (p<0.03). Effect modification by race, sex and inci-dent stroke on AF and cognitive decline were also detected. In conclusion, AF was associ-ated with poorer baseline cognitive performance across multiple domains and incident cognitive impairment in this bi-racial cohort. Additional adjustment for cardiovascular risk factors attenuated these relations with the exception of learning. (C) 2021 Elsevier Inc. All rights reserved.
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Details
- Title
- Relation of Atrial Fibrillation to Cognitive Decline (from the REasons for Geographic and Racial Differences in Stroke [REGARDS] Study)
- Creators
- Margie J. Bailey - Wake Forest UniversityElsayed Z. Soliman - Wake Forest UniversityLeslie A. McClure - Drexel UniversityGeorge Howard - University of Alabama at BirminghamVirginia J. Howard - University of Alabama at BirminghamSuzanne E. Judd - University of Alabama at BirminghamFrederick W. Unverzagt - Indiana UniversityVirginia Wadley - Department of Medicine, University of Alabama at Birmingham, Winston-Salem, North CarolinaBonnie C. Sachs - Wake Forest UniversityTimothy M. Hughes - Wake Forest University
- Publication Details
- The American journal of cardiology, v 148, pp 60-68
- Publisher
- Elsevier
- Number of pages
- 9
- Grant note
- U01 NS041588 / National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health, Department of Health and Human Service; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Neurological Disorders & Stroke (NINDS) U01 NS041588 / National Institute on Aging (NIA) , National Institutes of Health, Department of Health and Human Service
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000655650300009
- Scopus ID
- 2-s2.0-85103047340
- Other Identifier
- 991019169787204721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems