{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T11:06:03Z","timestamp":1779793563670,"version":"3.53.1"},"reference-count":45,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,1,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Atrial electrophysiological abnormalities (AEA) are associated with cognitive dysfunction. We evaluated the associations of AEA with longitudinal cognitive decline and incident dementia and investigated underlying mechanisms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      In subjects without atrial fibrillation followed prospectively for 5\u2009years, 12\u2010lead ECGs were evaluated for AEA, defined as the presence of sinus node dysfunction (SND), frequent premature atrial complexes, advanced interatrial block (a\u2010IAB), or P\u2010terminal force in V1 (&gt;40\u2009mm*ms). Rate of decline in global cognition (\n                      <jats:italic toggle=\"no\">Z<\/jats:italic>\n                      \u2010score averaged from 6 cognitive domains), Clinical Dementia Rating\u2013Sum of Boxes score, and associations with cerebrovascular disease on neuroimaging and circulating biomarkers of neurodegenerative disease were determined.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Among 358 subjects (age 73.3\u00b17.6\u2009years, 55% female, 47% dementia), 188 (53%) had AEA (94 SND, 6 frequent premature atrial complexes, 52 a\u2010IAB, 92 P\u2010terminal force in V1 &gt;40\u2009mm*ms). Compared with non\u2010AEA, AEA was associated with accelerated decline in both global cognition and Clinical Dementia Rating\u2013Sum of Boxes score (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      <jats:sub>interaction<\/jats:sub>\n                      &lt;0.05), 2 times\u00a0increased risk of dementia in competing risk analyses, and increased burden of cortical infarcts, lacunes, and cerebral microinfarcts (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.05). Among AEA subtypes, SND (versus non\u2010SND) and a\u2010IAB (versus non\u2010a\u2010IAB) both associated with accelerated decline in global cognition and Clinical Dementia Rating\u2013Sum of Boxes score (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      <jats:sub>interaction<\/jats:sub>\n                      &lt;0.05). a\u2010IAB was associated with 3 times increased risk of incident ischemic stroke and P\u2010terminal force in V1 with increased burden of lacunes. SND was associated with increased burden of cerebral microinfarcts and cerebral microbleeds, incident cerebral microbleeds, higher circulating pTau\u2010181 levels, and increased odds of Alzheimer disease among subjects with preexisting dementia (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">AEA is associated with worse cognitive trajectories and increased cerebrovascular disease burden. These associations may be underpinned by AEA\u2010subtype\u2010specific mechanisms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.045054","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T10:24:59Z","timestamp":1767090299000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Association of Atrial Electrophysiological Abnormalities With Cognitive Decline and Cerebrovascular Disease"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7273-6883","authenticated-orcid":false,"given":"Eugene S. 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