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55/100

✓ Peer-reviewed alzhub usefulness score 55 out of 100. Disparities

Topic: Amyloid, tau and blood-test diagnosis

Plain-language summary

Background Previous studies have reported that atrial fibrillation (AF) is associated with cognitive decline and dementia. These studies, however, had limited follow-up, were based mostly on white and highly selected populations, and did not account for attrition. We evaluated the association of incident AF with 20-year change in cognitive performance (accounting for attrition) and incident dementia in the ARIC (Atherosclerosis Risk in Communities) Study. Methods and results We analyzed data from 12 515 participants (mean age, 56.9 [SD, 5.7] years in 1990-1992; 56% women and 24% black) from 1990 to 1992 through 2011 to 2013. Incident AF was ascertained from study ECGs and hospital discharge codes. Cognitive tests were performed in 1990 to 1992, 1996 to 1998, and 2011 to 2013. Incident dementia was clinician adjudicated. We used generalized estimating equations and Cox proportional hazards models to assess the association of time-dependent AF with change in Z scores of cognitive tests and incident dementia, respectively. During 20 years, 2106 participants developed AF and 1157 participants developed dementia. After accounting for cardiovascular risk factors, including ischemic stroke, the average decline over 20 years in global cognitive Z score was 0.115 (95% confidence interval, 0.014-0.215) greater in participants with AF than in those without AF. Further adjustment for attrition by multiple imputation by chained equations strengthened the association. In addition, incident AF was associated with an increased risk of dementia (hazard ratio, 1.23; 95% confidence interval, 1.04-1.45), after adjusting for cardiovascular risk factors, including ischemic stroke. Conclusions AF is associated with greater cognitive decline and increased risk of dementia, independent of ischemic stroke. Because cognitive decline is a precursor to dementia, our findings prompt further investigation to identify specific treatments for AF that will delay the trajectory of cognitive decline and, thus, prevent dementia in patients with AF.

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APA 7th

Chen, L. Y., Norby, F. L., Gottesman, R. F., Mosley, T. H., Soliman, E. Z., Agarwal, S. K., et al. (2018). Association of Atrial Fibrillation With Cognitive Decline and Dementia Over 20 Years: The ARIC-NCS (Atherosclerosis Risk in Communities Neurocognitive Study). Journal of the American Heart Association. https://doi.org/10.1161/jaha.117.007301

Vancouver

Chen LY, Norby FL, Gottesman RF, Mosley TH, Soliman EZ, Agarwal SK, et al. Association of Atrial Fibrillation With Cognitive Decline and Dementia Over 20 Years: The ARIC-NCS (Atherosclerosis Risk in Communities Neurocognitive Study). Journal of the American Heart Association. 2018. doi:10.1161/jaha.117.007301. PMID: 29514809.

BibTeX

@article{chen2018-29514809,
  author  = {Chen, L. Y. and Norby, F. L. and Gottesman, R. F. and Mosley, T. H. and Soliman, E. Z. and Agarwal, S. K. and Loehr, L. R. and Folsom, A. R. and others},
  title   = {{Association of Atrial Fibrillation With Cognitive Decline and Dementia Over 20 Years: The ARIC-NCS (Atherosclerosis Risk in Communities Neurocognitive Study)}},
  journal = {Journal of the American Heart Association},
  year    = {2018},
  doi     = {10.1161/jaha.117.007301},
  pmid    = {29514809},
  url     = {https://doi.org/10.1161/jaha.117.007301}
}

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How to read this study

Design: our record does not state a study design, so check the methods section of the original before weighing the result.
Size: the record lists 515 participants. Ask whether that is enough for the question, and who they were.
Effect: the record gives no effect size, so the summary above cannot say how large any difference was.

What the evidence grade means here

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Key findings

Background Previous studies have reported that atrial fibrillation (AF) is associated with cognitive decline and dementia.
Methods and results We analyzed data from 12 515 participants (mean age, 56.9 [SD, 5.7] years in 1990-1992; 56% women and 24% black) from 1990 to 1992 through 2011 to 2013.
In addition, incident AF was associated with an increased risk of dementia (hazard ratio, 1.23; 95% confidence interval, 1.04-1.45), after adjusting for cardiovascular risk factors, including ischemic stroke.
Conclusions AF is associated with greater cognitive decline and increased risk of dementia, independent of ischemic stroke.
Because cognitive decline is a precursor to dementia, our findings prompt further investigation to identify specific treatments for AF that will delay the trajectory of cognitive decline and, thus, prevent dementia in patients with AF.

Why it matters

Over 20 years, participants who developed atrial fibrillation had a greater decline in global cognitive score and a higher risk of dementia than those without it, after adjusting for cardiovascular risk factors including ischemic stroke. This identifies atrial fibrillation as a risk factor but does not test whether treating it prevents dementia.

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Study details

Participants515
Evidence strengthLow

How this study scored 55/100

Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomized / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 53 of the 96 points we could judge it on, which is 55 out of 100.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (Journal of the American Heart Association)
Journal's citation record	2 / 4	Journal of the American Heart Association: journal h-index 200 (OpenAlex, 2026-10-29)
Study design	0 / 12	No study design recorded — scores zero, not guessed (not stated in the record — scored 0)
Strength of evidence	1 / 5	Rated “low” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	2 / 5	2018 — within 10 year(s) of the newest study here
Sample size	2 / 4	515 participants
Effect reported	0 / 3	No effect size reported — scores zero (not stated in the record — scored 0)
Studied in people	3 / 3	Studied in people (participant count stated)
Randomized / blinded	0 / 2	No randomization or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	5 / 7	Cited 163 times (OpenAlex, 2026-10-10)
Citations per year	3 / 5	16.3 citations a year over 10 year(s) since 2018
Impact for its field and year	4 / 6	Cited 10.0× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	2 / 6	Cited by 4 other studies in this library
Still being cited	3 / 4	Cited 66 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	— / 4	Senior author's record not available — left out of this score
Institution's track record	2 / 3	Johns Hopkins University: institution h-index 2,306 (OpenAlex)
Multicenter collaboration	3 / 3	OpenAlex lists 10 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 29514809)
Free to read	2 / 2	Free to read
Points	53 / 96	Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 53 of the 96 points we could judge it on is 55 out of 100.
Total	55 / 100	—

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