Original article
Atrial Fibrillation Is Associated With Lower Cognitive Performance in the Framingham Offspring Men

https://doi.org/10.1016/j.jstrokecerebrovasdis.2006.05.009Get rights and content

The purpose of this study was to investigate the association of atrial fibrillation (AFIB) with multiple measures of cognitive performance in a large community-based sample extensively characterized for vascular risk factors. Our primary analysis included 1011 Framingham Offspring Study (Framingham, Mass) men, mean age = 61.0 (37-89) years, free of clinical stroke and dementia. Using multivariable linear regression models, we related the presence (n = 59) versus absence (n = 952) of AFIB in men to a global measure of performance and multiple measures of specific cognitive abilities assessed an average of 8 months after the AFIB surveillance period. Adjusting for age, education, multiple cardiovascular risk factors, and cardiovascular disease, men with AFIB exhibited significantly lower mean levels of cognitive performance compared with men in normal sinus rhythm. Men with AFIB exhibited lower performance on global cognitive ability and cognitive abilities including Similarities (abstract reasoning), Visual Reproductions-Immediate Recall, Visual Reproductions-Delayed Recall, Visual Organization, Logical Memory-Delayed Recall, and Trail Making A (scanning and tracking) and Trail Making B (scanning, tracking, and executive functioning). Further studies leading to a better understanding of the mechanisms underlying the relation between AFIB and cognitive performance are important.

Section snippets

Study Sample

The Framingham Offspring Study participants, recruited in 1971, were biological children or related by marriage to a biological child of members of the original Framingham Heart Study cohort. Participants were examined 7 times during a 30-year period to identify risk factors for cardiovascular and cerebrovascular disease. All 1506 male Offspring Study members who participated in the seventh examination were eligible for the current investigation. Women were not excluded from the sample by

Results

To evaluate potential sample bias, men who participated in this study were compared with those men who were excluded because of lack of neuropsychologic test data. The pattern of results was the same for men in the AFIB and non-AFIB groups. In general, men who were included in our study exhibited lower (P < .05) mean systolic blood pressure (126 v 128 mm Hg), lower prevalence of hypertension (33% v 41%), and drank less alcohol (101 v 118 mL/wk) but did not differ from participants with respect

Discussion

Compared with their counterparts in normal sinus rhythm, men with a history of AFIB performed more poorly on a composite of cognitive abilities and on a range of cognitive performance measures. In our study, as in the two previous large community-based studies,15, 16 AFIB was associated with a measure of overall cognitive ability. Ott et al16 used the MMSE and Kilander et al15 used the MMSE and the Trails A and B tests in a composite score. In our study, global ability was indexed by a

Acknowledgment

The authors wish to express their appreciation to Greg Dore for his assistance in technical aspects of manuscript preparation and copy editing, and to Amanda Goodell and Anna Sweeney (University of Maine) for their diligent assistance in copy editing.

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    Supported by the National Heart, Lung, and Blood Institute (NHLBI)’s Framingham Heart Study; the National Institutes of Health (NIH)/NHLBI contract NO1-HC-25195; NIH/National Institute on Aging (NIA) grant 5RO1-AGO8122; NIH/NIA grant 5RO1-AG16495; NIH/National Institute of Neurological Disorders and Stroke grant 5RO1-NS17950; NIH/NHLBI grant NO1-HC-25195; NIH/NHLBI grant 1RO1-HL081290; NIH/NHLBI grant 1RO1-HL67358; the Boston University Alzheimer’s Disease Center (grant P30 AG13846); and a midcareer investigator award NIH (2K24HL004334) (Dr. Vasan).

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