103Atrial Fibrillation and Cognition at Four Year Follow Up – Data from The Irish Longitudinal Study on Ageing (TILDA)

Abstract

Background: Atrial fibrillation (AF) is the most common sustained arrhythmia, and is associated with an increased risk of stroke, heart failure and increased mortality. Emerging evidence suggests AF may be associated with an increased risk of cognitive impairment, however results are conflicting. The aim of this study is to assess whether AF is associated with a decline in global cognition at four year follow-up. Methods: Data from waves 1 and 3 of the Irish Longitudinal Study on Ageing were used. At wave 1, participants who attended the health centre underwent ECG which were screened for AF by clinicians. Global cognition was assessed at the health centre, using the Montreal Cognitive Assessment (MOCA), and this was repeated at wave 3 (4 year follow-up period). Information on covariates was obtained via a computer aided personal interview and during the health assessment. Mixed effects poisson regression was performed to assess whether there was an increased rate of errors in MOCA at 4 year follow-up in participants with AF. Results: Participants with a baseline diagnosis of dementia, stroke or Parkinson's disease, or who had inadequate ECG or MOCA data at wave 1, were excluded. Of those included, 3651 had a follow-up MOCA at wave 3, of whom 74 (2.05%) had AF on ECG. Results of mixed effects poisson regression found an increased rate of errors on MOCA in participants with AF at follow-up (IRR 1.16; 95% CI 1.01, 1.35; p-value 0.037), however this was no longer significant on controlling for age, sex, education, medication use, smoking status, alcohol, blood pressure, cardiovascular comorbidities, depressive symptoms and frailty (IRR 1.09; 95% CI 0.88, 1.35; p-value 0.447). Conclusion: AF was not associated with an increase rate of errors on MOCA at 4 year follow-up, adjusting for confounders, in a community dwelling population over the age of 50 in Ireland.