Atrial fibrillation and risk of dementia: a prospective cohort study.
Atrial fibrillation and risk of dementia: a prospective cohort study.
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DOI：
10.1111/j.1532-5415.2011.03508.x
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发表时间：
2011-08
影响因子：
6.3
通讯作者：
Larson EB
中科院分区：
文献类型：
--
作者：
Dublin S;Anderson ML;Haneuse SJ;Heckbert SR;Crane PK;Breitner JC;McCormick W;Bowen JD;Teri L;McCurry SM;Larson EB
房颤可能会增加患痴呆症的风险，但之前的研究得出了相互矛盾的结果。许多人能量不足或痴呆症程度有限。我们调查了除了对中风的影响外，心房颤动是否与痴呆症或阿尔茨海默病风险增加有关。一项前瞻性队列研究综合医疗保健提供系统1994-2008年跟踪调查了3045名65岁及以上无痴呆症或临床中风的社区成年人的基于人口的样本。房颤是从健康计划电子数据中识别出来的，使用国际疾病分类第9版，住院患者和门诊患者的代码。协变量来自自我报告、研究措施和健康计划数据。参与者每两年使用认知能力筛查工具(得分范围为0-100)进行筛查，对得分低于86分的参与者进行详细的神经心理和临床评估。全因痴呆症和可能或可能的阿尔茨海默病的结果由一个多学科共识委员会使用标准研究标准确定。在基线时，3,045名参与者中有132人(4.3%)出现了心房颤动，在平均6.8年的随访期中，有370人(12.2%)被诊断为房颤。572名参与者(18.8%)患上了痴呆症(449名患有阿尔茨海默病)。全因痴呆合并房颤的调整风险比为1.38(95%可信区间1.10~1.73)，可能或可能阿尔茨海默病的调整风险比为1.50(95%可信区间1.16~1.94)。在随访期间，无论有没有临床确诊的中风患者，以及仅检查可能的阿尔茨海默病的敏感性分析中，结果都是相似的。房颤与罹患阿尔茨海默病和痴呆症的风险较高有关。未来的研究应该检查包括最佳抗凝在内的特定治疗是否可以降低这种风险。
Atrial fibrillation may increase dementia risk, but prior studies yielded conflicting results. Many had low power or limited measures of dementia. We investigated whether atrial fibrillation is associated with increased risk of incident dementia or Alzheimer disease, beyond its effect on stroke. A prospective cohort study An integrated healthcare delivery system A population-based sample of 3,045 community-dwelling adults age 65 and older without dementia or clinical stroke, followed from 1994-2008. Atrial fibrillation was identified from health plan electronic data using International Classification of Diseases, version 9, codes from inpatient and outpatient encounters. Covariates came from self-report, study measures, and health plan data. Participants were screened every 2 years with the Cognitive Abilities Screening Instrument (score range, 0-100), with detailed neuropsychological and clinical assessment of those scoring less than 86. The outcomes of all-cause dementia and possible or probable Alzheimer disease were determined by a multidisciplinary consensus committee using standard research criteria. Atrial fibrillation was present in 132/3,045 (4.3%) participants at baseline and was diagnosed in 370 (12.2%) more over a mean of 6.8 years of follow-up. 572 participants (18.8%) developed dementia (449 with Alzheimer disease). The adjusted hazard ratio for all-cause dementia associated with atrial fibrillation was 1.38 (95% CI 1.10-1.73) and for possible or probable Alzheimer disease, 1.50 (95% CI 1.16-1.94). Results were similar for participants with or without clinically recognized stroke during follow-up and in sensitivity analyses examining only probable Alzheimer disease. Atrial fibrillation is associated with higher risk of developing Alzheimer disease and dementia. Future studies should examine whether specific treatments including optimal anticoagulation can decrease this risk.
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影响因子：
8.3
作者：
LAVY, S;STERN, S;LEVY, P
通讯作者：
LEVY, P
影响因子：
--
作者：
Glazer, Nicole L.;Dublin, Sascha;Heckbert, Susan R.
通讯作者：
Heckbert, Susan R.
影响因子：
6.7
作者：
Park, Helen;Hildreth, Anthony;O'Connell, Janice
通讯作者：
O'Connell, Janice
影响因子：
7.2
作者：
Okura, Y;Urban, LH;Rodeheffer, RJ
通讯作者：
Rodeheffer, RJ
影响因子：
2.8
作者：
Naccarelli, Gerald V.;Varker, Helen;Schulman, Kathy L.
通讯作者：
Schulman, Kathy L.