Atrial Fibrillation is Associated With Reduced Brain Volume and Cognitive Function Independent of Cerebral Infarcts
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Background and Purpose—: Atrial fibrillation (AF) has been associated with cognitive decline independent of stroke, suggesting additional effects of AF on the brain. We aimed to assess the association between AF and brain function and structure in a general elderly population. Methods—: This is a cross-sectional analysis of 4251 nondemented participants (mean age, 76±5 years) in the population-based Age, Gene/Environment Susceptibility-Reykjavik Study. Medical record data were collected for the presence, subtype, and time from first diagnosis of AF; 330 participants had AF. Brain volume measurements, adjusted for intracranial volume, and presence of cerebral infarcts were determined with magnetic resonance imaging. Memory, speed of processing, and executive function composites were calculated from a cognitive test battery. In a multivariable linear regression model, adjustments were made for demographic factors, cardiovascular risk factors, and cerebral infarcts. Results—: Participants with AF had lower total brain volume compared with those without AF ( P <0.001). The association was stronger with persistent/permanent than paroxysmal AF and with increased time from the first diagnosis of the disease. Of the brain tissue volumes, AF was associated with lower volume of gray and white matter hyperintensities ( P <0.001 and P =0.008, respectively), but not of white matter hyperintensities ( P =0.49). Participants with AF scored lower on tests of memory. Conclusions—: AF is associated with smaller brain volume, and the association is stronger with increasing burden of the arrhythmia. These findings suggest that AF has a cumulative negative effect on the brain independent of cerebral infarcts.
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Other causes of cognitive impairment induced by global reductions in cerebral perfusion include cardiac arrest, severe cardiac failure, arrhythmias, and severe hypotension.
“Other causes of cognitive impairment induced by global reductions in cerebral perfusion include cardiac arrest, severe cardiac failure, arrhythmias, and severe hypotension. 91-94”
From Vascular Cognitive Impairment (2017) · cites this paper as [94]
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Cites
Studies of interference in serial verbal reactions
Stroop, J. R. (1935) · Journal of Experimental Psychology · doi:10.1037/h0054651 · Cited by 18,622 · see citing works
Development and validation of a geriatric depression screening scale: a preliminary report
Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1982) · Journal of Psychiatric Research · doi:10.1016/0022-3956(82)90033-4 · Cited by 15,025 · see citing works
Guidelines for the management of atrial fibrillation
Authors/Task Force Members, Camm, A. J., Kirchhof, P. F., Lip, G. Y. H., Schotten, U., Savelieva, I., Ernst, S., Gelder, I. C. V., Al‐Attar, N., Hindricks, G., et al. (2010) · European Heart Journal · doi:10.1093/eurheartj/ehq278 · Cited by 5,875 · see citing works
The Cardiovascular Health Study: design and rationale.
Fried, L. P., Borhani, N. O., Enright, P., Furberg, C. D., Gardin, J. M., Kronmal, R. A., Kuller, L. H., Manolio, T. A., Mittelmark, M. B., Newman, A., et al. (1991) · Annals of Epidemiology · doi:10.1016/1047-2797(91)90005-w · Cited by 3,652 · see citing works
Decomposing adult age differences in working memory
Salthouse, T. A., & Babcock, R. L. (1991) · Developmental Psychology · doi:10.1037/0012-1649.27.5.763 · Cited by 1,373 · see citing works
Pathogenesis of Leukoaraiosis: A Review
Pantoni, L., & Garcia, J. H. (1997) · Stroke · doi:10.1161/01.str.28.3.652 · Cited by 1,225 · see citing works
Wada, K., Tanaka, K., & Nakashima, K. (2011) · PubMed · Cited by 1,132 · see citing works
Robbins, T. W., James, M., Owen, A. M., Sahakian, B. J., McInnes, L., & Rabbitt, P. (1994) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000106735 · Cited by 1,078 · see citing works
Automatic "pipeline" analysis of 3-D MRI data for clinical trials: application to multiple sclerosis
Zijdenbos, A. P., Forghani, R., & Evans, A. C. (2002) · IEEE Transactions on Medical Imaging · doi:10.1109/tmi.2002.806283 · Cited by 755 · see citing works
Atrial Fibrillation and Dementia in a Population-Based Study: The Rotterdam Study
Ott, A., Breteler, M. M. B., de Bruyne, M. C., van Harskamp, F., Grobbee, D. E., & Hofman, A. (1997) · Stroke · doi:10.1161/01.str.28.2.316 · Cited by 732 · see citing works
Age, Gene/Environment Susceptibility-Reykjavik Study: multidisciplinary applied phenomics
Harris, T. B., Launer, L. J., Eiriksdottir, G., Kjartansson, O., Jonsson, P. V., Sigurdsson, G., Thorgeirsson, G., Aspelund, T., Garcia, M. E., Cotch, M. F., et al. (2007) · American Journal of Epidemiology · doi:10.1093/aje/kwk115 · Cited by 592 · see citing works
Self-citationCamm, A. J., Kirchhof, P. F., Lip, G. Y. H., Schotten, U., Savelieva, I., Ernst, S., Gelder, I. C. V., Al‐Attar, N., Hindricks, G., Prendergast, B., et al. (2011) · European Heart Journal · doi:10.1093/eurheartj/ehq512 · Cited by 555 · see citing works
Manolio, T. A., Kronmal, R. A., Burke, G. L., Poirier, V. C., O’Leary, D. H., Gardin, J. M., Fried, L. P., Steinberg, E. P., & Bryan, R. N. (1994) · Stroke · doi:10.1161/01.str.25.2.318 · Cited by 457 · see citing works
Atrial fibrillation is independently associated with senile, vascular, and Alzheimer's dementia
Bunch, T. J., Weiss, J. P., Crandall, B. G., May, H. T., Bair, T. L., Osborn, J. S., Anderson, J. L., Muhlestein, J. B., Horne, B. D., Lappe, D. L., et al. (2010) · Heart Rhythm · doi:10.1016/j.hrthm.2009.12.004 · Cited by 405 · see citing works
Bunch, T. J., Crandall, B. G., Weiss, J. P., May, H. T., Bair, T. L., Osborn, J. S., Anderson, J. L., Muhlestein, J. B., Horne, B. D., LAPPE, D. L., et al. (2011) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2011.02035.x · Cited by 398 · see citing works
Knecht, S., Oelschläger, C., Duning, T., Lohmann, H., Albers, J., Stehling, C., Heindel, W. L., Breithardt, G., Berger, K., Ringelstein, E. B., et al. (2008) · European Heart Journal · doi:10.1093/eurheartj/ehn341 · Cited by 356 · see citing works
Cardiac Index Is Associated With Brain Aging: The Framingham Heart Study
Jefferson, A. L., Himali, J. J., Beiser, A. S., Au, R., Massaro, J. M., Seshadri, S., Gona, P., Salton, C. J., DeCarli, C., O'Donnell, C. J., et al. (2010) · Circulation · doi:10.1161/circulationaha.109.905091 · Cited by 256 · see citing works
Cerebral microbleeds in the population based AGES-Reykjavik study: prevalence and location
Sveinbjörnsdóttir, S., Sigurdsson, S. O., Aspelund, T., Kjartansson, Ó., Eiríksdóttir, G., Valtysdottir, B., López, O. L., van Buchem, M. A., Jónsson, P. V., Gudnason, V. G., et al. (2008) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.2007.121913 · Cited by 242 · see citing works
Self-citationDifferential regional vulnerability in transient focal cerebral ischemia.
Marcoux, F. W., Morawetz, R. B., Crowell, R. M., DeGirolami, U., & Halsey, J. H. (1982) · Stroke · doi:10.1161/01.str.13.3.339 · Cited by 234 · see citing works
Stroke risk profile, brain volume, and cognitive function
Seshadri, S. S., Wolf, P. A., Beiser, A., Elias, M. F., Au, R., Kase, C. S., D’Agostino, R. B., & DeCarli, C. S. (2004) · Neurology · doi:10.1212/01.wnl.0000142968.22691.70 · Cited by 230 · see citing works
Trends in the incidence and prevalence of atrial fibrillation in Iceland and future projections
Stefansdottir, H., Aspelund, T., Gudnason, V. G., & Arnar, D. O. (2011) · EP Europace · doi:10.1093/europace/eur132 · Cited by 182 · see citing works
Self-citationBrain tissue volumes in relation to cognitive function and risk of dementia
Ikram, M. A., Vrooman, H. A., Vernooij, M. W., den Heijer, T., Albert Hofman, D., Niessen, W. J., van der Lugt, A., Koudstaal, P. J., & Breteler, M. M. B. (2008) · Neurobiology of Aging · doi:10.1016/j.neurobiolaging.2008.04.008 · Cited by 152 · see citing works
Regional Ischemic Vulnerability of the Brain to Hypoperfusion
Payabvash, S., Souza, L. C. S., Wang, Y., Schaefer, P. W., Furie, K. L., Halpern, E. F., González, R., & Lev, M. H. (2011) · Stroke · doi:10.1161/strokeaha.110.600940 · Cited by 151 · see citing works
Effect of chronic atrial fibrillation on regional cerebral blood flow.
LAVY, S., Stern, S., Melamed, E., Cooper, G., Keren, A., & Levy, P. (1980) · Stroke · doi:10.1161/01.str.11.1.35 · Cited by 148 · see citing works
Cerebral Blood Flow before and after Cardioversion of Atrial Fibrillation
Petersen, P., Kastrup, J., Videbæk, R., & Boysen, G. (1989) · Journal of Cerebral Blood Flow & Metabolism · doi:10.1038/jcbfm.1989.62 · Cited by 116 · see citing works
Brain tissue volumes in the general population of the elderly
Sigurdsson, S. O., Aspelund, T., Forsberg, L. E., Fredriksson, J., Kjartansson, Ó., Oskarsdottir, B., Jónsson, P. V., Eiríksdóttir, G., Harris, T. B., Zijdenbos, A. P., et al. (2011) · NeuroImage · doi:10.1016/j.neuroimage.2011.11.024 · Cited by 103 · see citing works
Self-citationAtrial Fibrillation Is Associated With Lower Cognitive Performance in the Framingham Offspring Men
Elias, M. F., Sullivan, L. M., Elias, P. K., Vasan, R. S., D’Agostino, R. B., Seshadri, S., Au, R., Wolf, P. A., & Benjamin, E. J. (2006) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2006.05.009 · Cited by 80 · see citing works
Atrial fibrillation and cognitive function: case-control study
O’Connell, J., Gray, C., French, J. M., & Robertson, I. H. (1998) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.65.3.386 · Cited by 74 · see citing works
White Matter Lesions and Cognitive Performance: The Role of Cognitively Complex Leisure Activity
Saczynski, J. S., Jónsdóttir, M. K., Sigurdsson, S. O., Eiríksdóttir, G., Jónsson, P. V., Garcia, M., Kjartansson, Ó., van Buchem, M. A., Gudnason, V. G., & Launer, L. J. (2008) · The Journals of Gerontology Series A · doi:10.1093/gerona/63.8.848 · Cited by 73 · see citing works
Self-citationCorrelation of Echocardiographic Findings With Cerebral Infarction in Elderly Adults
McAreavey, D., Vidal, J., Aspelund, T., et al. (2010) · Stroke · doi:10.1161/strokeaha.110.590430 · Cited by 10 · see citing works
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- [31]Seshadri S Wolf PA Beiser A Elias MF Au R Kase CS Stroke risk profile, brain volume, and cognitive function: The Framingham Offspring Study Neurology 2004 63 1591 1599 15534241
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The Pathobiology of Vascular Dementia
Iadecola, C. (2013) · Neuron · doi:10.1016/j.neuron.2013.10.008 · Cited by 1,857 · see citing works
Global epidemiology of atrial fibrillation
Rahman, F., Kwan, G. F., & Benjamin, E. J. (2014) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2014.118 · Cited by 731 · see citing works
Less dementia with oral anticoagulation in atrial fibrillation
Friberg, L., & Rosenqvist, M. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehx579 · Cited by 279 · see citing works
Atrial fibrillation as a risk factor for cognitive decline and dementia
Singh-Manoux, A., Fayosse, A., Sabia, S., Canonico, M., Bobak, M., Elbaz, A., Kivimäki, M., & Dugravot, A. (2017) · European Heart Journal · doi:10.1093/eurheartj/ehx208 · Cited by 186 · see citing works
Atrial Fibrillation, Cognitive Decline, and Dementia: an Epidemiologic Review
Ding, M., & Qiu, C. (2018) · Current Epidemiology Reports · doi:10.1007/s40471-018-0159-7 · Cited by 57 · see citing works
Dichgans, M., & Leys, D. (2017) · Circulation Research · doi:10.1161/circresaha.116.308426 · Cited by 581 · see citing works
- Authors
- Stefansdottir, H., Arnar, D. O., Aspelund, T., Sigurdsson, S., Jonsdottir, M. K., Hjaltason, H., Launer, L. J., & Gudnason, V.
- Affiliations
- National Institutes of Health (US)
- From the Faculty of Medicine, University of Iceland, Reykjavik, Iceland (H.S., D.O.A., T.A., V.G.); Department of Medicine, Cardiovascular Research Center, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland (D.O.A.); The Icelandic Heart Association, Kopavogur, Iceland (T.A., S.S., M.K.J., V.G.); Faculty of Psychology, University of Iceland, Reykjavik, Iceland (M.K.J.); Department of Neurology, Landspitali- The National University Hospital of Iceland, Reykjavik, Iceland (H.H....
- Venue
- Stroke
- Published
- 2013-04
- Volume
- 44
- Issue
- 4
- Pages
- 1020-1025
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- PMC
- PMC3632359
- OpenAlex
- W2050291997
- Cited by
- 166
- References
- 30
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 14 · 2023: 10 · 2022: 18 · 2021: 14 · 2020: 17 · 2019: 17 · 2018: 20 · 2017: 12 · 2016: 9 · 2015: 9 · 2014: 6 · 2013: 4
- FWCI
- 6.34
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Hirsla (Landspítali University Hospital) (submittedVersion, other-oa)
- Funders
- National Institutes of Health (n01ag12100-57-0-2)
- National Institute on Aging (N01-AG12100, N01-AG012100)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Keywords
- atrial fibrillation, brain volume, cognitive function, cerebral infarction, white matter hyperintensities, memory, executive function, processing speed, persistent atrial fibrillation, aging
- MeSH terms
- Aged, Aged, 80 and over, Atrial Fibrillation, Brain, Cerebral Infarction, Cognition, Cognition Disorders, Cross-Sectional Studies, Female, Humans, Magnetic Resonance Imaging, Male, Regression Analysis, Risk Factors, Cohort Studies, Outcome Assessment, Health Care, Genetic Predisposition to Disease
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