A cross-sectional analysis of racial differences in accelerated aging and cognitive function among patients with atrial fibrillation: The SAGE-AF study

Abstract

Background Non-Whites are more likely to suffer from cognitive impairment and complications of atrial fibrillation (AF) than Whites, though Whites are more likely to be diagnosed with AF. We examined whether non-Whites with AF are biologically older than Whites with AF and whether accelerated biological aging is associated with cognitive functioning. Methods We used baseline data from the ongoing Systematic Assessment of Geriatric Elements in Atrial Fibrillation prospective cohort study, collected 2016–2020 across ambulatory care practices in Massachusetts and Georgia. Of 1244 enrolled, 974 participants with full biological data were included in the present analysis. Accelerated aging (AccA) was calculated based on a combination of biomarkers associated with age and physiological “wear and tear.” Findings The main outcome was score on Montreal Cognitive Assessment (MoCA). Non-Whites had 2.9 years more AccA than Whites and higher AccA was associated with a lower MoCA score among both Whites (-0.06, 95% CI: -0.10, -0.03) and non-Whites (-0.14, 95% CI: -0.27, 0.02). This association was significantly greater among non-whites (-0.11, 95% CI: -0.20, -0.01). Interpretation Non-White AF patients are functionally “older” than their White counterparts and experience a stronger deleterious association between AccA and cognition. These findings underscore the importance of taking functional age into account when treating patients with AF, particularly non-White patients, to enhance treatment and improve AF outcomes.

Association of biological age with health outcomes and its modifiable factors

“…Accelerated aging was associated with various categories of diseases. Recent studies have shown that aging acceleration was associated with cardiovascular diseases, depression and anxiety, diabetes, and cognitive impairment (Chen et al, 2023 ; Forrester et al, 2021 ; Gao et al, 2023 ; Gialluisi et al, 2022 ). Our study identified some novel associations of biological age gap, thus expanding the clinical significance of biological aging.…”

Does Periodontitis Affect the Association of Biological Aging with Mortality?

“…In this study, non-Hispanic Whites may be more susceptible to periodontal intervention for preventing aging-related mortality. Since non-Hispanic Whites have less accelerated aging than other races (Forrester et al 2021), they are prone to reverse or slow the aging process by modifiable risk factors. However, future large-scale randomized controlled trials are needed to confirm the beneficial effect of periodontal health care and treatment of periodontitis on delaying the aging process and reducing death rates in the middle-aged and older population.…”