{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T18:04:42Z","timestamp":1788631482398,"version":"build-2803163510"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"23","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,12,3]]},"abstract":"\n Background<\/jats:title>\n \n Atrial fibrillation (\n AF<\/jats:styled-content>\n ) is associated with cognitive decline. Whether left atrial enlargement (\n LAE<\/jats:styled-content>\n ), a critical substrate for\n AF,<\/jats:styled-content>\n is also associated is less well established. Therefore, we assessed the association of\n LAE<\/jats:styled-content>\n and\n AF<\/jats:styled-content>\n with cognitive decline in the ARIC\u2010NCS (Atherosclerosis Risk in Communities Neurocognitive Study).\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Participants (n=3391; mean age, 75\u00b15\u00a0years; 59% women) underwent cognitive tests and 2\u2010dimensional echocardiograms at visit 5 (2011\u20132013) and follow\u2010up cognitive tests at visit 6 (2016\u20132017).\n LAE<\/jats:styled-content>\n was defined as left atrium volume index \u226534\u00a0mL\/m\n 2<\/jats:sup>\n .\n AF<\/jats:styled-content>\n was ascertained using study\n ECG<\/jats:styled-content>\n s and hospitalization discharge codes. We assessed the association of\n AF<\/jats:styled-content>\n and\n LAE<\/jats:styled-content>\n with (a) cognitive domain scores at visit 5 and (b) cognitive domain score changes between visit 5 and visit 6. At visit 5, compared with the reference group (without\n AF<\/jats:styled-content>\n , normal left atrium), participants with\n LAE<\/jats:styled-content>\n and\n AF<\/jats:styled-content>\n had significantly lower global cognition (\n Z<\/jats:italic>\n score, \u22120.24; 95%\n CI,<\/jats:styled-content>\n \u22120.38 to \u22120.10), whereas participants with\n AF<\/jats:styled-content>\n and without\n LAE<\/jats:styled-content>\n and participants with\n LAE<\/jats:styled-content>\n and without\n AF<\/jats:styled-content>\n did not have lower global cognition. In longitudinal analysis, compared with the reference group, participants with\n AF<\/jats:styled-content>\n but without\n LAE<\/jats:styled-content>\n had significantly greater decline in global cognition (\n Z<\/jats:italic>\n score, \u22120.13; 95%\n CI,<\/jats:styled-content>\n \u22120.21 to \u22120.06). However,\n LAE,<\/jats:styled-content>\n with or without\n AF,<\/jats:styled-content>\n was not associated with greater cognitive decline.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Although\n LAE<\/jats:styled-content>\n with\n AF<\/jats:styled-content>\n was significantly associated with lower cognitive function in cross\u2010sectional analysis,\n LAE,<\/jats:styled-content>\n with or without\n AF,<\/jats:styled-content>\n was not associated with greater cognitive decline over 5\u00a0years, highlighting the importance of evaluating longitudinal cognitive function. Future studies should have longer follow\u2010up and evaluate left atrium function.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.013197","type":"journal-article","created":{"date-parts":[[2019,11,26]],"date-time":"2019-11-26T10:00:24Z","timestamp":1574762424000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":34,"title":["Association of Left Atrial Enlargement and Atrial Fibrillation With Cognitive Function and Decline: The ARIC\u2010NCS"],"prefix":"10.1161","volume":"8","author":[{"given":"Michael J.","family":"Zhang","sequence":"first","affiliation":[{"name":"Cardiovascular Division Department of Medicine University of Minnesota Medical School Minneapolis MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faye L.","family":"Norby","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Community Health School of Public Health University of Minnesota Minneapolis MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela L.","family":"Lutsey","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Community Health School of Public Health University of Minnesota Minneapolis MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas H.","family":"Mosley","sequence":"additional","affiliation":[{"name":"The MIND Center, University of Mississippi Medical Center Jackson MS"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca J.","family":"Cogswell","sequence":"additional","affiliation":[{"name":"Cardiovascular Division Department of Medicine University of Minnesota Medical School Minneapolis MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suma H.","family":"Konety","sequence":"additional","affiliation":[{"name":"Cardiovascular Division Department of Medicine University of Minnesota Medical School Minneapolis MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tze\u2010Fan","family":"Chao","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Taipei Veterans General Hospital Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amil M.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Medicine Brigham and Women's Hospital Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott D.","family":"Solomon","sequence":"additional","affiliation":[{"name":"Department of Medicine Brigham and Women's Hospital Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvaro","family":"Alonso","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Rollins School of Public Health Emory University Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin Y.","family":"Chen","sequence":"additional","affiliation":[{"name":"Cardiovascular Division Department of Medicine University of Minnesota Medical School Minneapolis MN"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.22.8.983"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.96.7.2455"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-158-5-201303050-00007"},{"key":"e_1_3_2_5_2","first-page":"792","article-title":"Atrial enlargement as a consequence of atrial fibrillation:","volume":"82","author":"Sanfilippo AJ","year":"1990","unstructured":"Sanfilippo AJ, Abascal VM, Sheehan M, Oertel LB, Harrigan P, Hughes RA, Weyman AE. 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