Growing evidence suggests that AF is also a risk factor for significant cognitive decline through pathways that may be mediated by stroke, or risk factors shared with stroke. AF is associated with increased chances of stroke,, cardiovascular disease, dementia and death. Additional adjustment for cardiovascular risk factors attenuated these relations with the exception of learning.Ītrial fibrillation (AF) is the most common form of sustained cardiac arrhythmia observed in clinical practice and can influence cognitive and physical function. In conclusion, AF was associated with poorer baseline cognitive performance across multiple domains and incident cognitive impairment in this bi-racial cohort. Effect modification by race, sex and incident stroke on AF and cognitive decline were also detected. During a mean follow-up of 8.06 years, steeper declines in list learning were observed among participants with AF (p<0.03) which remained significant after adjusting for cardiovascular risk factors (p<0.04) and incident stroke (p<0.03). AF was associated with poorer baseline performance on measures of: semantic fluency (p<0.01) global cognitive performance (MoCA, p<0.01) and WLD (p<0.01). AF was present in 2,168 (8.3%) participants at baseline. Models were adjusted sequentially for age, sex, race, geographic region, and education, then cardiovascular risk factors and finally incident stroke. Multivariable regression models estimated the relationships between AF and baseline impairment and time to cognitive impairment. Cognitive testing was conducted yearly with the Six Item Screener (SIS) to define impairment and at 2-year intervals to assess decline on: animal naming and letter fluency, Montreal Cognitive Assessment (MoCA), Word List Learning (WLL) and Delayed Recall tasks (WLD).
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Baseline AF was identified by self-reported medical history or electrocardiogram (ECG). This analysis included 25,980 black and white adults, aged 48+, from the national REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort, free from cognitive impairment and stroke at baseline.
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The association of atrial fibrillation (AF) with cognitive function remains unclear, especially among racially/geographically diverse populations.