PO-02-159 ABLATION OF ATRIAL FIBRILLATION AND DEMENTIA RISK REDUCTION DURING LONG-TERM FOLLOW-UP: A NATIONWIDE POPULATION-BASED STUDY

Abstract

Growing evidence supports the hypothesis that AF is an independent risk factor for cognitive decline and dementia. Few studies have reported results regarding the subtypes of dementia in patients with AF in Asia. This study investigated the epidemiological characteristics of new-onset dementia in patients with AF and the effect of catheter ablation on different subtypes of dementia. We conducted a population-based, retrospective cohort study using data from the Taiwan National Health Insurance Research Database. In total, 136,774 patients without a history of dementia were selected after 1:1 propensity score matching based on age (with AF versus without AF). A competing risk model was used to investigate the three subtypes of dementia: Alzheimer's disease, vascular dementia, and other/mixed dementia. After a median follow-up period of 6.6 years, 8704 events of new-onset dementia occurred. Among all AF patients developing dementia, 73% were classified as having Alzheimer's disease, 16% as having vascular dementia, and 11% as having other/mixed dementia. The crude incidence of dementia in AF patients was higher (total dementia: 18.89 vs. 21.11, Alzheimer's disease: 15.13 vs. 16.81, vascular dementia: 2.08 vs. 3.77, and other/mixed dementia: 2.01 vs. 2.59 [per 1000 person-years, non-AF controls vs. AF patients]; all P < 0.001). In patients with AF undergoing catheter ablation, the total dementia risk decreased significantly (P = 0.015, hazard ratio: 0.74, 95% confidence interval: 0.58−0.94) after multivariable adjustment, but not for the subtype of vascular dementia (P = 0.59, hazard ratio: 0.86, 95% confidence interval: 0.49−1.50). Patients with AF have a higher incidence of all types of dementia, including Alzheimer's disease, vascular dementia, and a mixed type of dementia. Alzheimer's disease is less likely to occur in patients with AF undergoing catheter ablation.