Atrial Fibrillation is Associated With Greater Risk of Dementia in Older Veterans

Objectives: To examine the association of atrial fibrillation (AF) with incident dementia in older veterans and the effect of anticoagulation on that association. Methods: Around 407,871 veterans aged >= 55 years receiving care from US Veterans Health Administration between August 2003 and September 2015 were included in our retrospective study. AF and incident dementia were deter-mined according to ICD-9-CM codes. Logistic regressions with veterans grouped into high-dimensional propensity scores deciles were used, and a mediation analysis was employed to examine the extent of cardio/cerebrovascular diseases that may also account for that association. Results: AF was associated with greater dementia risk (odds ratio = 1.14; 95% confidence interval 1.07-1.22), partially mediated by cardio/cerebrovascular disease. Among veterans with AF taking anticoagulants, the risk of dementia was 44% higher (odds ratio = 1.44; 95% CI 1.27-1.63) compared to those without anticoagulants, likely related to AF severity. Conclusion: Our findings underscore the importance of considering cognitive function in the management of AF patients.