| Cognitive Impairment Associated With Atrial Fibrillation: A Meta-analysis. | |
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MedLine Citation:
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PMID: 23460057 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: Atrial fibrillation (AF) has been linked with an increased risk for cognitive impairment and dementia. PURPOSE: To complete a meta-analysis of studies examining the association between AF and cognitive impairment. DATA SOURCES: Search of MEDLINE, PsycINFO, Cochrane Library, CINAHL, and EMBASE databases and hand search of article references. STUDY SELECTION: Prospective and nonprospective studies reporting adjusted risk estimates for the association between AF and cognitive impairment. DATA EXTRACTION: Two abstracters independently extracted data on study characteristics, risk estimates, methods of AF and outcome ascertainment, and methodological quality. DATA SYNTHESIS: Twenty-one studies were included in the meta-analysis. Atrial fibrillation was significantly associated with a higher risk for cognitive impairment in patients with first-ever or recurrent stroke (relative risk [RR], 2.70 [95% CI, 1.82 to 4.00]) and in a broader population including patients with or without a history of stroke (RR, 1.40 [CI, 1.19 to 1.64]). The association in the latter group remained significant independent proof of clinical stroke history (RR, 1.34 [CI, 1.13 to 1.58]). However, there was significant heterogeneity among studies of the broader population (I2 = 69.4%). Limiting the analysis to prospective studies yielded similar results (RR, 1.36 [CI, 1.12 to 1.65]). Restricting the analysis to studies of dementia eliminated the significant heterogeneity (P = 0.137) but did not alter the pooled estimate substantially (RR, 1.38 [CI, 1.22 to 1.56]). LIMITATIONS: There is an inherent bias because of confounding variables in observational studies. There was significant heterogeneity among included studies. CONCLUSION: Evidence suggests that AF is associated with a higher risk for cognitive impairment and dementia, with or without a history of clinical stroke. Further studies are required to elucidate the association between AF and subtypes of dementia as well as the cause of cognitive impairment. PRIMARY FUNDING SOURCE: Deane Institute for Integrative Research in Atrial Fibrillation and Stroke at the Massachusetts General Hospital. |
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Authors:
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Shadi Kalantarian; Theodore A Stern; Moussa Mansour; Jeremy N Ruskin |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Annals of internal medicine Volume: 158 ISSN: 1539-3704 ISO Abbreviation: Ann. Intern. Med. Publication Date: 2013 Mar |
Date Detail:
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Created Date: 2013-03-05 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372351 Medline TA: Ann Intern Med Country: United States |
Other Details:
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Languages: eng Pagination: 338-46 Citation Subset: AIM; IM |
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