{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:59:39Z","timestamp":1791230379753,"version":"4.1.0"},"reference-count":24,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2020,11,14]],"date-time":"2020-11-14T00:00:00Z","timestamp":1605312000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Health and Welfare","award":["HI15C1200, HC19C0130"],"award-info":[{"award-number":["HI15C1200, HC19C0130"]}]},{"DOI":"10.13039\/501100008005","name":"Yonsei University College of Medicine","doi-asserted-by":"publisher","award":["6-2019-0124"],"award-info":[{"award-number":["6-2019-0124"]}],"id":[{"id":"10.13039\/501100008005","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Atrial fibrillation (AF) is considered a risk factor for dementia, especially in the elderly. However, the association between the two diseases is not well identified in different age subgroups. The association of incident AF with the development of dementia was assessed from 1 January 2005, to 31 December 2013, in 428,262 participants from a longitudinal cohort (the Korea National Health Insurance Service-Health Screening cohort). In total, 10,983 participants were diagnosed with incident AF during the follow-up period. The incidence of dementia was 11.3 and 3.0 per 1000 person-years in the incident-AF and without-AF groups, respectively. After adjustment for clinical variables, the risk of dementia was significantly elevated by incident AF, with a hazard ratio (HR) of 1.98 (95% confidence interval [CI]: 1.80\u20132.17, p &lt; 0.001), even after censoring for stroke (HR: 1.74, 95% CI: 1.55\u20131.94, p &lt; 0.001). The HRs of incident AF for dementia onset before the age of 65 (early-onset dementia) and for onset after the age of 65 (late-onset dementia) were 2.91 (95% CI: 1.93\u20134.41) and 1.67 (95% CI: 1.49\u20131.87), respectively. Younger participants with AF were more prone to dementia development than older participants with AF (p for trend &lt; 0.001). AF was associated with an increased risk of both early- and late-onset dementia, independent of clinical stroke.<\/jats:p>","DOI":"10.3390\/jcm9113665","type":"journal-article","created":{"date-parts":[[2020,11,16]],"date-time":"2020-11-16T21:48:52Z","timestamp":1605563332000},"page":"3665","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Atrial Fibrillation Increases the Risk of Early-Onset Dementia in the General Population: Data from a Population-Based Cohort"],"prefix":"10.3390","volume":"9","author":[{"given":"Dongmin","family":"Kim","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, College of Medicine, Dankook University, Cheonan-si, Chungnam 31116, Korea"},{"name":"Department of Medicine, The Graduate School, Yonsei University, Seoul 03722, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6552-1742","authenticated-orcid":false,"given":"Pil-Sung","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, CHA Bundang Medical Centre, CHA University, Seongnam 13496, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y.H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart &amp; Chest Hospital, Liverpool L14 3PE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9036-7225","authenticated-orcid":false,"given":"Boyoung","family":"Joung","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,11,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"56","DOI":"10.4070\/kcj.2016.0045","article-title":"The Trends of Atrial Fibrillation-Related Hospital Visit and Cost, Treatment Pattern and Mortality in Korea: 10-Year Nationwide Sample Cohort Data","volume":"47","author":"Lee","year":"2017","journal-title":"Korean Circ. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.ahj.2018.04.017","article-title":"10-year nationwide trends of the incidence, prevalence, and adverse outcomes of non-valvular atrial fibrillation nationwide health insurance data covering the entire Korean population","volume":"202","author":"Kim","year":"2018","journal-title":"Am. Heart J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/S0002-9343(02)01236-6","article-title":"A population-based study of the long-term risks associated with atrial fibrillation: 20-year follow-up of the Renfrew\/Paisley study","volume":"113","author":"Stewart","year":"2002","journal-title":"Am. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/alzrt143","article-title":"Dementia: A global health priority\u2014Highlights from an ADI and World Health Organization report","volume":"4","author":"Wortmann","year":"2012","journal-title":"Alzheimer\u2019s Res. Ther."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1161\/01.STR.28.2.316","article-title":"Atrial fibrillation and dementia in a population-based study. The Rotterdam Study","volume":"28","author":"Ott","year":"1997","journal-title":"Stroke"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1454","DOI":"10.1161\/STROKEAHA.106.477299","article-title":"Atrial fibrillation, stroke, and cognition: A longitudinal population-based study of people aged 85 and older","volume":"38","author":"Rastas","year":"2007","journal-title":"Stroke"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1016\/j.hrthm.2009.12.004","article-title":"Atrial fibrillation is independently associated with senile, vascular, and Alzheimer\u2019s dementia","volume":"7","author":"Bunch","year":"2010","journal-title":"Heart Rhythm"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2313","DOI":"10.1093\/eurheartj\/ehz386","article-title":"Risk of dementia in stroke-free patients diagnosed with atrial fibrillation: Data from a population-based cohort","volume":"40","author":"Kim","year":"2019","journal-title":"Eur. Heart J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e016640","DOI":"10.1136\/bmjopen-2017-016640","article-title":"Cohort profile: The National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) in Korea","volume":"7","author":"Seong","year":"2017","journal-title":"BMJ Open"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1524","DOI":"10.1161\/STROKEAHA.117.016926","article-title":"CHA2DS2-VASc Score (Congestive Heart Failure, Hypertension, Age >\/=75 [Doubled], Diabetes Mellitus, Prior Stroke or Transient Ischemic Attack [Doubled], Vascular Disease, Age 65\u201374, Female) for Stroke in Asian Patients With Atrial Fibrillation: A Korean Nationwide Sample Cohort Study","volume":"48","author":"Kim","year":"2017","journal-title":"Stroke"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1288","DOI":"10.1001\/jamaneurol.2015.2161","article-title":"Association Between Atrial Fibrillation and Dementia in the General Population","volume":"72","author":"Heeringa","year":"2015","journal-title":"JAMA Neurol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"183","DOI":"10.3233\/JAD-132363","article-title":"Heart diseases and long-term risk of dementia and Alzheimer\u2019s disease: A population-based CAIDE study","volume":"42","author":"Rusanen","year":"2014","journal-title":"J. Alzheimers Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/S1474-4422(13)70060-7","article-title":"Mechanisms of sporadic cerebral small vessel disease: Insights from neuroimaging","volume":"12","author":"Wardlaw","year":"2013","journal-title":"Lancet Neurol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.joa.2016.05.002","article-title":"EHRA\/HRS\/APHRS\/SOLAECE expert consensus on Atrial cardiomyopathies: Definition, characterisation, and clinical implication","volume":"32","author":"Goette","year":"2016","journal-title":"J. Arrhythm."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1038\/jcbfm.2015.116","article-title":"Circulating biologic markers of endothelial dysfunction in cerebral small vessel disease: A review","volume":"36","author":"Poggesi","year":"2016","journal-title":"J. Cereb. Blood Flow Metab. Off. J. Int. Soc. Cereb. Blood Flow Metab."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"67","DOI":"10.3233\/JAD-170160","article-title":"Framingham Risk Score and the Risk of Progression from Mild Cognitive Impairment to Dementia","volume":"59","author":"Viticchi","year":"2017","journal-title":"J. Alzheimers Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"713","DOI":"10.3233\/JAD-170544","article-title":"Interactions between Atrial Fibrillation, Cardiovascular Risk Factors, and ApoE Genotype in Promoting Cognitive Decline in Patients with Alzheimer\u2019s Disease: A Prospective Cohort Study","volume":"62","author":"Falsetti","year":"2018","journal-title":"J. Alzheimers Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1056\/NEJMoa022066","article-title":"Silent brain infarcts and the risk of dementia and cognitive decline","volume":"348","author":"Vermeer","year":"2003","journal-title":"N. Engl. J. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1612","DOI":"10.1001\/jamainternmed.2013.9079","article-title":"Risk factors in late adolescence for young-onset dementia in men: A nationwide cohort study","volume":"173","author":"Nordstrom","year":"2013","journal-title":"JAMA Intern. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1136\/jnnp-2014-309033","article-title":"Vascular comorbidities in younger people with dementia: A cross-sectional population-based study of 616,245 middle-aged people in Scotland","volume":"86","author":"Heath","year":"2015","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"157","DOI":"10.2147\/VHRM.S53203","article-title":"Strokes in young adults: Epidemiology and prevention","volume":"11","author":"Smajlovic","year":"2015","journal-title":"Vasc. Health Risk. Manag."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1186\/s13195-018-0442-3","article-title":"Variability in metabolic parameters and risk of dementia: A nationwide population-based study","volume":"10","author":"Lee","year":"2018","journal-title":"Alzheimer\u2019s Res. Ther."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.3233\/JAD-170445","article-title":"Sleep Apnea, Cognitive Profile, and Vascular Changes: An Intriguing Relationship","volume":"60","author":"Buratti","year":"2017","journal-title":"J. Alzheimers Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1378\/chest.15-0229","article-title":"Severity of OSA is an independent predictor of incident atrial fibrillation hospitalization in a large sleep-clinic cohort","volume":"148","author":"Cadby","year":"2015","journal-title":"Chest"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/11\/3665\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:33:24Z","timestamp":1760178804000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/11\/3665"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,14]]},"references-count":24,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2020,11]]}},"alternative-id":["jcm9113665"],"URL":"https:\/\/doi.org\/10.3390\/jcm9113665","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,14]]}}}