Relation of Diabetes Mellitus to Incident Dementia in Patients With Atrial Fibrillation (from the Atherosclerosis Risk in Communities Study)

Jiayaspathi, Ashwini; Chen, Lin Y.; Selvin, Elizabeth; Gottesman, Rebecca F.; Knopman, David S.; Mosley, Thomas H.; Norby, Faye L.; Alonso, Álvaro

doi:10.1016/j.amjcard.2021.11.005

Cited by 4 publications

(6 citation statements)

References 22 publications

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“…Using ARIC surveillance methods and data from in‐person ARIC assessments, dementia was identified from the time of discrimination assessment (JHS Exam 1) through ARIC visit 6 using previously described methods (Figure 1). 33,34 At ARIC visits 5 and 6, dementia classification was based on a comprehensive cognitive and functional exam, using criteria of the National Institute on Aging–Alzheimer's Association (NIA‐AA) workgroups and the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM‐5) 35,36 . Algorithmic diagnoses were then confirmed by expert clinical adjudicators, which included both a physician and a neuropsychologist.…”

Section: Methodsmentioning

confidence: 99%

“…Using ARIC surveillance methods and data from in-person ARIC assessments, dementia was identified from the time of discrimination assessment (JHS Exam 1) through ARIC visit 6 using previously described methods (Figure 1). 33,34 At ARIC visits 5 and 6, dementia hospital discharge codes, diagnostic codes from death certificates, and retrospectively from informant interview (Clinical Dementia Rating…”

Section: Dementia Ascertainmentmentioning

confidence: 99%

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The association of perceived discrimination with dementia risk in Black older adults

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Huang

Cordon

et al. 2023

Alzheimer's & Dementia

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INTRODUCTIONNon‐Hispanic Black, compared to non‐Hispanic White, older adults are at increased risk for dementia. This may be due partly to greater exposure to psychosocial stressors, such as discrimination; however, few studies have examined this association.METHODSWe examined the association of perceived discrimination (e.g., everyday, lifetime, and discrimination burden) with dementia risk in 1583 Black adults co‐enrolled in the Atherosclerosis Risk in Communities (ARIC) Study and the Jackson Heart Study (JHS). Perceived discrimination (defined continuously and using tertiles) was assessed at JHS Exam 1 (2000–2004; mean age ± SD:66.2 ± 5.5) and related to dementia risk through ARIC visit 6 (2017) using covariate‐adjusted Cox proportional hazards models.RESULTSAssociations of perceived everyday, lifetime, and burden of discrimination with dementia risk were not supported in age‐adjusted models or demographic‐ and cardiovascular health‐adjusted models. Results were similar across sex, income, and education.DISCUSSIONIn this sample, associations between perceived discrimination and dementia risk were not supported.Highlights In Black older adults perceived discrimination not associated with dementia risk. Younger age and greater education linked to greater perceived discrimination. Older age and less education among factors associated with dementia risk. Factors increasing exposure to discrimination (education) are also neuroprotective.

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Section: Methodsmentioning

confidence: 99%

Section: Dementia Ascertainmentmentioning

confidence: 99%

The association of perceived discrimination with dementia risk in Black older adults

Dark

Huang

Cordon

et al. 2023

Alzheimer's & Dementia

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“…1,24 Multifactorial mechanisms underlying the association between AF and cognitive dysfunction have been proposed, either by shared pathophysiology of AF and dementia or mediated through silent or overt cerebral cardioembolism. 2,[25][26][27][28] As diabetic patients with AF conferred a 45% higher risk for incident dementia as compared with those without diabetes, 4 there was limited data on whether SGLT2i could still be beneficial among this high-risk subpopulation. In previous studies investigating the association between SGLT2i and incident dementia, only less than 10% of the study participants had AF.…”

Section: Sodium-glucose Co-transporter-2 Inhibitor and Reduced Dement...mentioning

confidence: 99%

“…Since AF and dementia may have shared risk factors such as diabetes mellitus, AF patients with diabetes have an even greater risk of incident dementia compared to those without diabetes. 4 Although previous studies have suggested a protective effect of oral anticoagulation on cognitive outcomes in patients with AF, 5,6 those considered low risk or do not have a clear indication for anticoagulation remain at risk of cognitive decline. A recently published meta-analysis suggested the beneficial effects of newer glucose-lowering drugs, including sodiumglucose co-transporter-2 inhibitors (SGLT2i) and dipeptidyl peptidase-4 inhibitors (DPP4i), in protecting humans against cognitive decline.…”

Section: Introductionmentioning

confidence: 99%

“…The prevalence of AF and dementia will continue to grow with the ageing population, causing a substantial burden to the global health system. Since AF and dementia may have shared risk factors such as diabetes mellitus, AF patients with diabetes have an even greater risk of incident dementia compared to those without diabetes 4 . Although previous studies have suggested a protective effect of oral anticoagulation on cognitive outcomes in patients with AF, 5,6 those considered low risk or do not have a clear indication for anticoagulation remain at risk of cognitive decline.…”

Section: Introductionmentioning

confidence: 99%

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The impact of sodium‐glucose co‐transporter‐2 inhibitors on dementia and cardiovascular events in diabetic patients with atrial fibrillation

Chen,

Chang,

Lin

et al. 2024

Diabetes Metabolism Res

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AimsThe effectiveness of sodium‐glucose co‐transporter‐2 inhibitors (SGLT2i) on incident dementia in patients with diabetes and atrial fibrillation (AF) remains unknown. This study aimed to investigate the association between SGLT2i and the risk of incident dementia in diabetic patients with AF, and to explore the interactions with oral anticoagulants or dipeptidyl peptidase‐4 inhibitors (DPP4i).Materials and MethodsWe conducted a cohort study using Taiwan's National Health Insurance Research Database. Patients with diabetes and AFwithout a prior history of established cardiovascular diseases, were identified. Using propensity score matching, 810 patients receiving SGLT2i were matched with 1620 patients not receiving SGLT2i. The primary outcome was incident dementia, and secondary outcomes included composite cardiovascular events and mortality.ResultsAfter up to 5 years of follow‐up, SGLT2i use was associated with a significantly lower risk of incident dementia (hazard: 0.71, 95% confidence interval: 0.51–0.98), particularly vascular dementia (HR: 0.44, 95% CI: 0.24–0.82). SGLT2i was related to reduced risks of AF‐related hospitalisation (HR: 0.72, 95% CI: 0.56–0.93), stroke (HR: 0.75, 95% CI: 0.60–0.94), and all‐cause death (HR: 0.33, 95% CI: 0.24–0.44). The protective effects were consistent irrespective of the concurrent use of non‐vitamin K antagonist oral anticoagulants (NOACs) or DPP4i.ConclusionsIn diabetic patients with AF, SGLT2i was associated with reduced risks of incident dementia, AF‐related hospitalisation, stroke, and all‐cause death. The protective effects were independent of either concurrent use of NOACs or DPP4i.

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Diabetes and atrial fibrillation: does the type of diabetes matter?

Samuel

Brophy

2022

European Journal of Preventive Cardiology

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Relation of Diabetes Mellitus to Incident Dementia in Patients With Atrial Fibrillation (from the Atherosclerosis Risk in Communities Study)

Cited by 4 publications

References 22 publications

The association of perceived discrimination with dementia risk in Black older adults

The association of perceived discrimination with dementia risk in Black older adults

The impact of sodium‐glucose co‐transporter‐2 inhibitors on dementia and cardiovascular events in diabetic patients with atrial fibrillation

Diabetes and atrial fibrillation: does the type of diabetes matter?

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