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Original research article
Stroke-independent contribution of atrial fibrillation to dementia: a meta-analysis
  1. Andrea Saglietto1,
  2. Mario Matta2,
  3. Fiorenzo Gaita3,
  4. Victoria Jacobs4,
  5. Thomas Jared Bunch4 and
  6. Matteo Anselmino1
  1. 1Division of Cardiology, Department of Medical Sciences, University of Turin, Città della Salute e della Scienza Hospital, Turin, Italy
  2. 2Electrophysiology Lab, Cardiology Division, Sant'Andrea Hospital, Turin, Italy
  3. 3Department of Cardiology, Clinica Pinna Pintor, Turin, Italy
  4. 4Intermountain Heart Institute, Intermountain Medical Center, Murray, Utah, USA
  1. Correspondence to Dr Andrea Saglietto; andrea.saglietto{at}live.com

Abstract

Background Atrial fibrillation (AF) is associated with an increased risk of dementia. It is presently unknown to what extent AF contributes to dementia onset independently from prevalent and incident cerebrovascular accidents (CVAs)/transient ischaemic attacks (TIAs).

Methods MEDLINE/PubMed and Embase databases were searched for prospective observational results, which produced risk estimates for dementia in AF patients, adjusted for prevalent and incident CVAs/TIAs.

Results Five prospective observational studies were included, comprising 61 008 patients, having a median follow-up of 12.5 years. Meta-analysis of observational results indicates an increased risk of dementia in AF, adjusted for cerebrovascular clinical events (HR 1.28, 95% CI 1.17 to 1.41, I2=0%). Funnel plot analysis did not reveal a statistically significant asymmetry. Meta-regression analysis did not indicate statistically significant associations between baseline study-level covariates and risk estimates.

Conclusion AF confers a nearly 30% increased risk of dementia, independently from CVAs/TIAs. Screening for AF and subsequent optimised management to lower risk of cranial injury could help in preventing dementia, a condition characterised by high social and healthcare costs.

  • atrial fibrillation

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors AS, MA, MM contributed to study design, articles search and analysis. AS, MA, MM, FG, TJB, VJ contributed to the writing of the manuscript.

  • Funding This study was performed thanks to the support of the “Compagnia di San Paolo” within the project “Progetti di Ricerca di Ateneo–2016: Cerebral hemodynamics during atrial fibrillation (CSTO 60444)” of the University of Turin, Italy.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data are available upon reasonable request.

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