Role of Ventricular Rate Response on Dementia in Cognitively Impaired Elderly Subjects with Atrial Fibrillation: A 10-Year Study

被引：90

作者：

Cacciatore, Francesco ^{[1
,2
]}

Testa, Gianluca ^{[3
]}

Langellotto, Assunta ^{[1
]}

Galizia, Gianluigi ^{[4
]}

Della-Morte, David ^{[4
,5
]}

Gargiulo, Gaetano ^{[1
]}

Bevilacqua, Agnese ^{[1
]}

Del Genio, Maria Teresa ^{[1
]}

Canonico, Vincenzo ^{[1
]}

Rengo, Franco ^{[1
,2
]}

Abete, Pasquale ^{[1
]}

机构：

[1] Univ Naples Federico II, Dipartimento Med Clin Sci Cardiovasc & Immunol, Cattedra Geriatria, IT-80131 Naples, Italy

[2] IRCCS, Fdn Salvatore Maugeri, Ist Sci Campoli Telese, Benevento, Italy

[3] Univ Molise, Dipartimento Med & Sci Salute, Campobasso, Italy

[4] IRCCS, Fdn Salvatore Maugeri, Ist Sci Veruno Novara, Div Recupero & Rieducaz Funz, Veruno, Italy

[5] IRCCS San Raffaele, Dept Adv Biotechnol & Bioimaging, Rome, Italy

来源：

DEMENTIA AND GERIATRIC COGNITIVE DISORDERS | 2012年 / 34卷 / 3-4期

关键词：

Atrial fibrillation; Rate ventricular response; Cognitive impairment; Incidence dementia; Cardiac output; ASYMPTOMATIC CEREBRAL INFARCTION; LONG-TERM MORTALITY; ALZHEIMERS-DISEASE; VASCULAR DEMENTIA; HEART-FAILURE; ASSOCIATION; PEOPLE; STATE; RISK;

D O I：

10.1159/000342195

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

Background: The role of ventricular rate response (VRr) on the incidence of dementia in elderly subjects with cognitive impairment and atrial fibrillation (AF) is not known. Thus, we examined the ability of VRr to predict dementia in cognitively impaired elderly subjects with and without AF. Methods: A total of 358 cognitively impaired elderly subjects (MMSE < 24) with and without AF were stratified in low/high (< 50/> 90) and moderate (> 50/< 90 bpm) VRr. A 10-year follow-up was performed. Results: Cognitively impaired subjects with dementia at the end of the follow-up were 135 (37.7%): 33 in the presence (75.0%) and 102 (32.5%) in the absence of AF (p < 0.001). Multivariate analysis shows that AF is a strong predictor of dementia (hazard ratio, HR = 4.10; 95% confidence interval, CI = 1.80-9.30, p < 0.001). More importantly, low/high VRr (< 50/> 90 bpm) is predictive of dementia in the presence (HR = 7.70, 95% CI = 1.10-14.20, p = 0.03) but not in the absence (HR = 1.85; 95% CI = 0.78-4.47; p = 0.152) of AF. Conclusions: This study demonstrates that AF predicts dementia in elderly subjects with cognitive impairment. Moreover, VRr seems to play a key role in the incidence of dementia in cognitively impaired elderly subjects with AF. Copyright (C) 2012 S. Karger AG, Basel

引用

页码：143 / 148

页数：6

共 31 条

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