{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T22:56:30Z","timestamp":1782946590627,"version":"3.54.5"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T00:00:00Z","timestamp":1715644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["5R01HL126911\u201004"],"award-info":[{"award-number":["5R01HL126911\u201004"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01HL13660"],"award-info":[{"award-number":["R01HL13660"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01HL137734"],"award-info":[{"award-number":["R01HL137734"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01HL137794"],"award-info":[{"award-number":["R01HL137794"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01HL141434"],"award-info":[{"award-number":["R01HL141434"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cognitive impairment is strongly associated with atrial fibrillation (AF). Rate and rhythm control are the two treatment strategies for AF and the effect of treatment strategy on risk of cognitive decline and frailty is not well established. We sought to determine how treatment strategy affects geriatric\u2010centered outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Systematic Assessment of Geriatric Elements\u2010AF (SAGE\u2010AF) was a prospective, observational, cohort study. Older adults with AF were prospectively enrolled between 2016 and 2018 and followed longitudinally for 2\u2009years. In a non\u2010randomized fashion, participants were grouped by rate or rhythm control treatment strategy based on clinical treatment at enrollment. Baseline characteristics were compared. Longitudinal binary mixed models were used to compare treatment strategy with respect to change in cognitive function and frailty status. Cognitive function and frailty status were assessed with the Montreal Cognitive Assessment Battery and Fried frailty phenotype tools.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      972 participants (mean age\u2009=\u200975, SD\u2009=\u20096.8; 49% female, 87% non\u2010Hispanic white) completed baseline examination and 2\u2010year follow\u2010up. 408 (42%) were treated with rate control and 564 (58%) with rhythm control. The patient characteristics of the two groups were different at baseline. Participants in the rate control group were older, more likely to have persistent AF, prior stroke, be treated with warfarin and have baseline cognitive impairment. After adjusting for baseline differences, participants treated with rate control were 1.5 times more likely to be cognitively impaired over 2\u2009years (adjusted OR: 1.47, 95% CI:1.12, 1.98) and had a greater decline in cognitive function (adjusted estimate: \u22120.59 (0.23),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) in comparison to rhythm control. Frailty did not vary between the treatment strategies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among those who had 2\u2010year follow\u2010up in non\u2010randomized observational cohort, the decision to rate control AF in older adults was associated with increased odds of decline in cognitive function but not frailty.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.18949","type":"journal-article","created":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T04:33:41Z","timestamp":1715661221000},"page":"2082-2090","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Cognitive impairment and treatment strategy for atrial fibrillation in older adults: The\n                    <scp>SAGE\u2010AF<\/scp>\n                    study"],"prefix":"10.1111","volume":"72","author":[{"given":"Deepti S.","family":"Athreya","sequence":"first","affiliation":[{"name":"College of Science Northeastern University  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane S.","family":"Saczynski","sequence":"additional","affiliation":[{"name":"Department of Pharmacy and Health System Sciences, Bouv\u00e9 College of Health Sciences Northeastern University  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerry H.","family":"Gurwitz","sequence":"additional","affiliation":[{"name":"Meyers Primary Care Institute and Division of Geriatric Medicine University of Massachusetts Medical School  Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin M.","family":"Monahan","sequence":"additional","affiliation":[{"name":"Evans Department of Medicine Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1645-5838","authenticated-orcid":false,"given":"Benita A.","family":"Bamgbade","sequence":"additional","affiliation":[{"name":"Department of Pharmacy and Health System Sciences, Bouv\u00e9 College of Health Sciences Northeastern University  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tenes J.","family":"Paul","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine University of Massachusetts Medical School  Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Sogade","sequence":"additional","affiliation":[{"name":"Department of Medicine Mercer University School of Medicine  Mercer Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darleen M.","family":"Lessard","sequence":"additional","affiliation":[{"name":"Division of Epidemiology of Chronic Diseases, Department of Quantitative Health Sciences University of Massachusetts Medical School  Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David D.","family":"McManus","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine University of Massachusetts Medical School  Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4562-6950","authenticated-orcid":false,"given":"Robert H.","family":"Helm","sequence":"additional","affiliation":[{"name":"Evans Department of Medicine Boston University Chobanian &amp; 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