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Original Article
Association Between Atrial Fibrillation and the Risk of Dementia in the Korean Elderly: A 10-Year Nationwide Cohort Study
Min-Ah Nah, Kyeong Soo Lee, Tae-Yoon Hwang
J Prev Med Public Health. 2020;53(1):56-63.   Published online January 3, 2020
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AbstractAbstract AbstractSummary PDF
The objective of this study was to determine the effect of atrial fibrillation (AF) on the risk of dementia in the Korean elderly.
A 10-year retrospective cohort study was conducted using the National Health Insurance Service-Senior Cohort database. We excluded those who were under 65 years of age as of January 2006 (n=46 113), those who were diagnosed with dementia between 2002 and 2005 (n=9086), and those with a history of stroke prior to AF diagnosis (n=8392). We used a Cox proportional hazards model with a time-varying covariate to determine whether AF is associated with the risk of dementia after adjusting for potential confounders.
In univariable Cox regression, the hazard ratio (HR) of dementia according to AF status was 1.28 (95% confidence interval [CI], 1.23 to 1.33). After adjusting for potential confounders, AF was found to increase the risk of dementia (HR, 1.12; 95% CI, 1.07 to 1.17), Alzheimer dementia (HR, 1.12; 95% CI, 1.07 to 1.17), and vascular dementia (HR, 1.10; 95% CI, 1.03 to 1.18). In patients diagnosed with AF, the incidence of dementia was lower (HR, 0.50; 95% CI, 0.47 to 0.52) in patients who were treated with oral anticoagulants.
Investigating the potential risk factors of dementia in an aged society is important. We found a slightly higher risk of dementia in those with AF than in those without AF, and we therefore concluded that AF is a potential risk factor for dementia.
Korean summary
본 연구에서는 국민건강보험공단 노인표본코호트 자료를 사용하여 심방세동의 유무가 치매의 발생위험과 연관되어 있는지 분석하였다. 잠재적인 교란변수들을 통제하여 분석한 결과 심방세동은 치매(HR 1.12, 95% CI 1.07 to 1.17), 알츠하이머 치매(HR 1.12, 95% CI 1.07 to 1.17), 혈관성 치매(HR 1.10, 95% CI 1.03 to 1.18) 발생과 연관되어 있는 것으로 나타났다. 한 편, 심방세동 환자에서의 항응고제 복용은 치매 발생위험(HR 0.50, 95% CI 0.47 to 0.52)을 감소시키는 것으로 나타났다.


Citations to this article as recorded by  
  • Effects of risk factors on the development and mortality of early- and late-onset dementia: an 11-year longitudinal nationwide population-based cohort study in South Korea
    Min Young Chun, Wonjeong Chae, Sang Won Seo, Hyemin Jang, Jihwan Yun, Duk L. Na, Dongwoo Kang, Jungkuk Lee, Dustin B. Hammers, Liana G. Apostolova, Sung-In Jang, Hee Jin Kim
    Alzheimer's Research & Therapy.2024;[Epub]     CrossRef
  • The effect of oral anticoagulants on the incidence of dementia in patients with atrial fibrillation: A systematic review and meta-analysis
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    International Journal of Cardiology Cardiovascular Risk and Prevention.2024; 21: 200282.     CrossRef
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  • A systematic review and meta‐analysis to determine the effect of oral anticoagulants on incidence of dementia in patients with atrial fibrillation
    Mingjie Lin, Wenqiang Han, Jingquan Zhong, Lin Wu
    International Journal of Clinical Practice.2021;[Epub]     CrossRef
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    International Journal of Geriatric Psychiatry.2021; 36(10): 1488.     CrossRef
  • Clinical Utility of the Pathogenesis-Related Proteins in Alzheimer’s Disease
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JPMPH : Journal of Preventive Medicine and Public Health