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Atrial fibrillation and dementia in a population-based study. The Rotterdam Study
Ott A, Breteler MM, de Bruyne MC, van Harskamp F, Grobbee DE, Hofman A.. Stroke, 1997-02-01
Topic: Risk, prevention and care in population studies
Background and purpose Atrial fibrillation is a frequent disorder in the elderly and a known risk factor for cerebrovascular stroke. We investigated the association of atrial fibrillation with dementia and cognitive impairment in a large cross-sectional, population-based study in the elderly. Methods Of the 6584 participants in the Rotterdam Study aged 55 to 106 years, detailed information on dementia status and ECG abnormalities was available. Dementia was diagnosed in three phases. First, participants were screened. Screen-positive subjects were tested further. Those with possible dementia underwent an extensive diagnostic workup. Dementia and dementia subtypes were diagnosed according to prevailing criteria. Cognitive impairment was defined as a Mini-Mental State Examination test score of Results Atrial fibrillation was diagnosed in 195, dementia in 276, and cognitive impairment in 635 subjects. We found significant positive associations of atrial fibrillation with both dementia and impaired cognitive function (age- and sex-adjusted odds ratios, 2.3 [95% confidence interval, 1.4 to 3.7] and 1.7 [95% confidence interval, 1.2 to 2.5]), respectively). The strongest association was found not for vascular dementia but rather for Alzheimer's disease with cerebrovascular disease. The associations were stronger in women, and the relation with dementia was more pronounced in the relatively younger elderly. A history of stroke in subjects with atrial fibrillation could not account for these associations. Conclusions Dementia and subtypes Alzheimer's disease and vascular dementia may be related to atrial fibrillation even if no clinical stokes have occurred.
Key findings
- Cognitive impairment was defined as a Mini-Mental State Examination test score of Results Atrial fibrillation was diagnosed in 195, dementia in 276, and cognitive impairment in 635 subjects.
- We found significant positive associations of atrial fibrillation with both dementia and impaired cognitive function (age- and sex-adjusted odds ratios, 2.3 [95% confidence interval, 1.4 to 3.7] and 1.7 [95% confidence interval, 1.2 to 2.5]), respectively).
Why it matters
In 6,584 older adults from the Rotterdam Study, people with atrial fibrillation were more likely to have dementia (age- and sex-adjusted odds ratio 2.3, 95% CI 1.4–3.7) and impaired cognition (1.7, 1.2–2.5). The strongest link was not with vascular dementia but with "Alzheimer's disease with cerebrovascular disease", and it was stronger in women and in the younger elderly. This was a one-time snapshot adjusted only for age and sex, so it shows the two conditions occur together, not that atrial fibrillation causes dementia or that treating it would prevent Alzheimer's.
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Study details
- Study designcross-sectional
- Participants6,584
- Evidence strengthLow
How this study scored 60/100
Published in a peer-reviewed journal, and it is a snapshot of people at one point in time. Scored zero for effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Stroke) |
| Journal's citation record | 3 / 4 | Stroke: journal h-index 455 (OpenAlex, 2026-10-29) |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| 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 | 1 / 5 | 1997 — older than 20 years, still counted |
| Sample size | 3 / 4 | 6,584 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) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 731 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 23.6 citations a year over 31 year(s) since 1997 |
| Impact for its field and year | 4 / 6 | Cited 13.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 29 other studies in this library |
| Still being cited | 3 / 4 | Cited 56 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Albert Hofman: h-index 207 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Erasmus MC: institution h-index 1,321 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 9040682) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 60 / 100 | — |
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Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Ott, A., Breteler, M. M., de Bruyne, M. C., van Harskamp, F., Grobbee, D. E., & Hofman, A. (1997). Atrial fibrillation and dementia in a population-based study. The Rotterdam Study. Stroke. https://doi.org/10.1161/01.str.28.2.316
Vancouver
Ott A, Breteler MM, de Bruyne MC, van Harskamp F, Grobbee DE, Hofman A. Atrial fibrillation and dementia in a population-based study. The Rotterdam Study. Stroke. 1997. doi:10.1161/01.str.28.2.316. PMID: 9040682.
BibTeX
@article{ott1997-9040682,
author = {Ott, A. and Breteler, M. M. and de Bruyne, M. C. and van Harskamp, F. and Grobbee, D. E. and Hofman, A.},
title = {{Atrial fibrillation and dementia in a population-based study. The Rotterdam Study}},
journal = {Stroke},
year = {1997},
doi = {10.1161/01.str.28.2.316},
pmid = {9040682},
url = {https://doi.org/10.1161/01.str.28.2.316}
}
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