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Relation of Diabetes Mellitus to Incident Dementia in Patients With Atrial Fibrillation (from the Atherosclerosis Risk in Communities Study).

TitleRelation of Diabetes Mellitus to Incident Dementia in Patients With Atrial Fibrillation (from the Atherosclerosis Risk in Communities Study).
Publication TypeJournal Article
Year of Publication2022
AuthorsJiayaspathi A, Chen LYee, Selvin E, Gottesman RF, Knopman DS, Mosley TH, Norby FL, Alonso A
JournalAm J Cardiol
Volume165
Pagination51-57
Date Published2022 02 15
ISSN1879-1913
KeywordsAged, Aged, 80 and over, Atrial Fibrillation, Blood Glucose, Cohort Studies, Dementia, Diabetes Mellitus, Female, Glycated Hemoglobin A, Humans, Incidence, Male, Multivariate Analysis, Prevalence, Proportional Hazards Models
Abstract

The association of diabetes mellitus (DM), an established risk factor for dementia in the general population, with incident dementia in patients with atrial fibrillation (AF) has not been explored. We performed a cohort study where we identified subjects with incident AF in the Atherosclerosis Risk in Communities cohort (1987 to 2017) and determined their DM status, fasting blood glucose before AF diagnosis and hemoglobin A1c levels using information from the closest previous study visit. Incident dementia was expert adjudicated using information from cognitive assessments, informant interviews and hospitalization surveillance. We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) of incident dementia for each level of exposure using Cox models and adjusting for potential confounders. We analyzed 3,020 patients with AF in the Atherosclerosis Risk in Communities cohort (808 with DM) and 530 had incident dementia after a mean follow-up of 5.3 years after AF diagnosis. After multivariable adjustment, patients with AF with prevalent DM had higher rates of dementia than those without DM, HR 1.45 (95% CI 1.16 to 1.80). A value of hemoglobin A1c ≥6.5% was associated with a HR 1.29 (95% CI 0.97 to 1.71) of dementia. However, fasting blood glucose was not associated with rates of dementia independent of DM status. In conclusion, DM was associated with higher rates of dementia in patients with AF. DM prevention and control could be a promising avenue for reducing risk of dementia in AF.

DOI10.1016/j.amjcard.2021.11.005
Alternate JournalAm J Cardiol
PubMed ID34887073
PubMed Central IDPMC8766899
Grant ListU01 HL096812 / HL / NHLBI NIH HHS / United States
K24 HL152440 / HL / NHLBI NIH HHS / United States
R01 DK089174 / DK / NIDDK NIH HHS / United States
U01 HL096902 / HL / NHLBI NIH HHS / United States
HHSN268201700002C / HL / NHLBI NIH HHS / United States
HHSN268201700001I / HL / NHLBI NIH HHS / United States
U01 HL096814 / HL / NHLBI NIH HHS / United States
R01 HL070825 / HL / NHLBI NIH HHS / United States
HHSN268201700003I / HL / NHLBI NIH HHS / United States
P30 AG066511 / AG / NIA NIH HHS / United States
U01 HL096917 / HL / NHLBI NIH HHS / United States
K24 HL148521 / HL / NHLBI NIH HHS / United States
HHSN268201700004I / HL / NHLBI NIH HHS / United States
HHSN268201700005C / HL / NHLBI NIH HHS / United States
HHSN268201700001C / HL / NHLBI NIH HHS / United States
HHSN268201700003C / HL / NHLBI NIH HHS / United States
U01 HL096899 / HL / NHLBI NIH HHS / United States
HHSN268201700004C / HL / NHLBI NIH HHS / United States
HHSN268201700002I / HL / NHLBI NIH HHS / United States
HHSN268201700005I / HL / NHLBI NIH HHS / United States