{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T10:39:05Z","timestamp":1792838345055,"version":"4.5.0"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,12,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Abnormal P\u2010wave indices (PWIs)\u2014reflecting underlying left atrial abnormality\u2014are associated with increased risk of stroke independent of atrial fibrillation. We assessed whether abnormal PWIs are associated with incident dementia and greater cognitive decline, independent of atrial fibrillation and ischemic stroke.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We included 13\u00a0714 participants (mean age, 57\u00b16\u00a0years; 56% women; 23% black) who were followed for dementia through the end of 2015. (Abnormal P\u2010wave terminal force in lead V1, \u22654000\u00a0\u03bcV\u00d7ms), abnormal P\u2010wave axis (&gt;75\u00b0 or &lt;0\u00b0), prolonged P\u2010wave duration (&gt;120\u00a0ms), and advanced interatrial block were determined from ECGs at visits 2 to 4. Dementia was adjudicated by an expert panel using data from cognitive tests and hospitalization\n              <jats:italic>International Classification of Diseases<\/jats:italic>\n              codes. Cognitive function was measured longitudinally using 3 neuropsychological tests. Cox proportional hazards models were used to assess the association between time\u2010dependent abnormal PWIs with incident dementia. Linear regression models were used to evaluate PWIs with cognitive function over time. At the conclusion of the study, 19%, 16%, 28%, and 1.9% of participants had abnormal P\u2010wave terminal force in lead V1, abnormal P\u2010wave axis, prolonged P\u2010wave duration, and advanced interatrial block, respectively. During mean follow\u2010up of 18\u00a0years, there were 1390 (10%) dementia cases. All abnormal PWIs except advanced interatrial block were associated with an increased risk of dementia even after adjustment for incident atrial fibrillation and stroke: multivariable hazard ratio of abnormal P wave terminal force in lead V1=1.60, 95% CI, 1.41 to 2.83; abnormal P\u2010wave axis, hazard ratio =1.36, 95% CI, 1.17 to 2.57; prolonged P\u2010wave duration, hazard ratio=1.60, 95% CI, 1.42 to 1.80. Only abnormal P\u2010wave terminal force in lead V1 was associated with greater decline in global cognition.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Abnormal PWIs are independently associated with an increased risk of dementia. This novel finding should be replicated in other cohorts and the underlying mechanisms should be evaluated.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.014553","type":"journal-article","created":{"date-parts":[[2019,12,13]],"date-time":"2019-12-13T10:00:19Z","timestamp":1576231219000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":49,"title":["Association of Abnormal P\u2010Wave Indices With Dementia and Cognitive Decline Over 25\u00a0Years: ARIC\u2010NCS (The Atherosclerosis Risk in Communities Neurocognitive Study)"],"prefix":"10.1161","volume":"8","author":[{"given":"Alejandra","family":"Gutierrez","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":"Ankit","family":"Maheshwari","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Department of Medicine University of Pennsylvania Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary R.","family":"Rooney","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":"Rebecca F.","family":"Gottesman","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas H.","family":"Mosley","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Mississippi 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