{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T16:48:07Z","timestamp":1790182087184,"version":"4.1.0"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,3,19]],"date-time":"2023-03-19T00:00:00Z","timestamp":1679184000000},"content-version":"vor","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003130","name":"Research Foundation Flanders","doi-asserted-by":"publisher","award":["11C0820N"],"award-info":[{"award-number":["11C0820N"]}],"id":[{"id":"10.13039\/501100003130","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Atrial fibrillation (AF) is associated with cognitive decline, with anticoagulated subjects potentially having a reduced risk compared with non-anticoagulated subjects. However, whether non-vitamin K antagonist oral anticoagulants (NOACs) may reduce the risk of dementia compared with vitamin K antagonists (VKAs) is unclear yet. Therefore, the risk of dementia was compared between AF subjects on NOACs versus VKAs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>AF subjects initiating anticoagulation between 2013 and 2019 were identified in Belgian nationwide data. Inverse probability of treatment weighted Cox regression was used to investigate cognitive outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 237,012 AF subjects (310,850 person-years (PYs)), NOAC use was associated with a significantly lower risk of dementia (adjusted hazard ratio (aHR) 0.91, 95% confidence interval (CI) (0.85\u20130.98)) compared with VKAs. A trend towards a lower risk of vascular dementia (aHR 0.89, 95%\u00a0CI (0.76\u20131.04)) and significantly lower risk of other\/unspecified dementia (aHR 0.91, 95%\u00a0CI (0.84\u20130.99)) were observed with NOACs compared with VKAs, whereas the risk of Alzheimer\u2019s disease was similar (aHR 0.99, 95%\u00a0CI (0.88\u20131.11)). Apixaban (aHR 0.91, 95%\u00a0CI (0.83\u20130.99)) and edoxaban (aHR 0.79, 95%\u00a0CI (0.63\u20130.99)) were associated with significantly lower risks of dementia compared with VKAs, while risks were not significantly different with dabigatran (aHR 1.02, 95% CI (0.93\u20131.12)) and rivaroxaban (aHR 0.97, 95% CI (0.90\u20131.05)). Comparable risks of dementia were observed between individual NOACs, except for significantly lower risks of dementia (aHR 0.93, 95% CI (0.87\u20130.98)) and other\/unspecified dementia (aHR 0.90 (0.84\u20130.97)) with apixaban compared with rivaroxaban.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>NOACs were associated with a significantly lower risk of dementia compared with VKAs, likely driven by apixaban and edoxaban use.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ageing\/afad038","type":"journal-article","created":{"date-parts":[[2023,3,19]],"date-time":"2023-03-19T14:06:23Z","timestamp":1679234783000},"source":"Crossref","is-referenced-by-count":22,"title":["Comparing the risk of dementia in subjects with atrial fibrillation using non-vitamin K antagonist oral anticoagulants versus vitamin K antagonists: a Belgian nationwide cohort study"],"prefix":"10.1093","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0145-6486","authenticated-orcid":false,"given":"Maxim","family":"Grymonprez","sequence":"first","affiliation":[{"name":"Ghent University Department of Bioanalysis, Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, , 9000 Ghent , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirko","family":"Petrovic","sequence":"additional","affiliation":[{"name":"Ghent University Hospital Department of Geriatrics, , 9000 Ghent , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tine L","family":"De Backer","sequence":"additional","affiliation":[{"name":"Ghent University Hospital Department of Cardiology, , 9000 Ghent , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M Arfan","family":"Ikram","sequence":"additional","affiliation":[{"name":"Erasmus Medical Center Department of Epidemiology, , 3000 Rotterdam, Th e 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