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Relation of Atrial Fibrillation to Cognitive Decline (from the REasons for Geographic and Racial Differences in Stroke [REGARDS] Study)
Journal article   Open access   Peer reviewed

Relation of Atrial Fibrillation to Cognitive Decline (from the REasons for Geographic and Racial Differences in Stroke [REGARDS] Study)

Margie J. Bailey, Elsayed Z. Soliman, Leslie A. McClure, George Howard, Virginia J. Howard, Suzanne E. Judd, Frederick W. Unverzagt, Virginia Wadley, Bonnie C. Sachs and Timothy M. Hughes
The American journal of cardiology, v 148, pp 60-68
01 Jun 2021
PMID: 33684372
url
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9730299View
Accepted (AM)Open Access (License Unspecified) Open

Abstract

Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Life Sciences & Biomedicine Science & Technology
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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Web of Science research areas
Cardiac & Cardiovascular Systems
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