Prediction of vascular dementia and Alzheimer's disease in patients with atrial fibrillation or atrial flutter using CHADS2 score

Ruey Hsing Chou, Chun Chih Chiu, Chin Chou Huang, Wan Leong Chan, Po Hsun Huang, Yu Chun Chen, Tzeng Ji Chen, Chia Min Chung, Shing Jong Lin, Jaw Wen Chen, Hsin Bang Leu

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background Atrial fibrillation (AF) is associated with an increased risk of dementia. However, limited data are available on the predictors of dementia in patients with AF. This study aimed to evaluate whether the CHADS2 score could be a useful tool for risk stratification with regard to dementia occurrence among patients with AF. Methods AF patients were identified from the National Health Insurance sampling database, which has accumulated a total of 1,000,000 participants since 2000. After excluding patients diagnosed with dementia prior to the index day of enrollment, CHADS2 score was measured to investigate its association with the occurrence of dementia, including vascular dementia and Alzheimer's disease. Results During the mean follow-up period of 3.71 ± 2.78 years, 1135 dementia cases (7.36%) were identified, including 241 cases of vascular dementia and 894 cases of Alzheimer's disease. In multivariate analysis, an increase of 1 point in the CHADS2 score was independently associated with a 54% increase in the risk of vascular dementia (hazard ratio = 1.54; 95% confidence interval, 1.41–1.69; p < 0.001) and a 40% increase in Alzheimer's disease (hazard ratio = 1.40; 95% confidence interval, 1.34–1.46; p < 0.001). Conclusion CHADS2 score is a useful predictor for the development of vascular dementia as well as Alzheimer's disease in patients with AF.

Original languageEnglish
Pages (from-to)470-476
Number of pages7
JournalJournal of the Chinese Medical Association
Volume79
Issue number9
DOIs
Publication statusPublished - Sep 1 2016
Externally publishedYes

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Atrial Flutter
Vascular Dementia
Vascular Diseases
Atrial Fibrillation
Dementia
Alzheimer Disease
Confidence Intervals
National Health Programs
Multivariate Analysis
Databases

Keywords

  • Alzheimer's disease
  • atrial fibrillation
  • CHADS2 score
  • dementia
  • stroke

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Prediction of vascular dementia and Alzheimer's disease in patients with atrial fibrillation or atrial flutter using CHADS2 score. / Chou, Ruey Hsing; Chiu, Chun Chih; Huang, Chin Chou; Chan, Wan Leong; Huang, Po Hsun; Chen, Yu Chun; Chen, Tzeng Ji; Chung, Chia Min; Lin, Shing Jong; Chen, Jaw Wen; Leu, Hsin Bang.

In: Journal of the Chinese Medical Association, Vol. 79, No. 9, 01.09.2016, p. 470-476.

Research output: Contribution to journalArticle

Chou, Ruey Hsing ; Chiu, Chun Chih ; Huang, Chin Chou ; Chan, Wan Leong ; Huang, Po Hsun ; Chen, Yu Chun ; Chen, Tzeng Ji ; Chung, Chia Min ; Lin, Shing Jong ; Chen, Jaw Wen ; Leu, Hsin Bang. / Prediction of vascular dementia and Alzheimer's disease in patients with atrial fibrillation or atrial flutter using CHADS2 score. In: Journal of the Chinese Medical Association. 2016 ; Vol. 79, No. 9. pp. 470-476.
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abstract = "Background Atrial fibrillation (AF) is associated with an increased risk of dementia. However, limited data are available on the predictors of dementia in patients with AF. This study aimed to evaluate whether the CHADS2 score could be a useful tool for risk stratification with regard to dementia occurrence among patients with AF. Methods AF patients were identified from the National Health Insurance sampling database, which has accumulated a total of 1,000,000 participants since 2000. After excluding patients diagnosed with dementia prior to the index day of enrollment, CHADS2 score was measured to investigate its association with the occurrence of dementia, including vascular dementia and Alzheimer's disease. Results During the mean follow-up period of 3.71 ± 2.78 years, 1135 dementia cases (7.36{\%}) were identified, including 241 cases of vascular dementia and 894 cases of Alzheimer's disease. In multivariate analysis, an increase of 1 point in the CHADS2 score was independently associated with a 54{\%} increase in the risk of vascular dementia (hazard ratio = 1.54; 95{\%} confidence interval, 1.41–1.69; p < 0.001) and a 40{\%} increase in Alzheimer's disease (hazard ratio = 1.40; 95{\%} confidence interval, 1.34–1.46; p < 0.001). Conclusion CHADS2 score is a useful predictor for the development of vascular dementia as well as Alzheimer's disease in patients with AF.",
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AU - Chou, Ruey Hsing

AU - Chiu, Chun Chih

AU - Huang, Chin Chou

AU - Chan, Wan Leong

AU - Huang, Po Hsun

AU - Chen, Yu Chun

AU - Chen, Tzeng Ji

AU - Chung, Chia Min

AU - Lin, Shing Jong

AU - Chen, Jaw Wen

AU - Leu, Hsin Bang

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N2 - Background Atrial fibrillation (AF) is associated with an increased risk of dementia. However, limited data are available on the predictors of dementia in patients with AF. This study aimed to evaluate whether the CHADS2 score could be a useful tool for risk stratification with regard to dementia occurrence among patients with AF. Methods AF patients were identified from the National Health Insurance sampling database, which has accumulated a total of 1,000,000 participants since 2000. After excluding patients diagnosed with dementia prior to the index day of enrollment, CHADS2 score was measured to investigate its association with the occurrence of dementia, including vascular dementia and Alzheimer's disease. Results During the mean follow-up period of 3.71 ± 2.78 years, 1135 dementia cases (7.36%) were identified, including 241 cases of vascular dementia and 894 cases of Alzheimer's disease. In multivariate analysis, an increase of 1 point in the CHADS2 score was independently associated with a 54% increase in the risk of vascular dementia (hazard ratio = 1.54; 95% confidence interval, 1.41–1.69; p < 0.001) and a 40% increase in Alzheimer's disease (hazard ratio = 1.40; 95% confidence interval, 1.34–1.46; p < 0.001). Conclusion CHADS2 score is a useful predictor for the development of vascular dementia as well as Alzheimer's disease in patients with AF.

AB - Background Atrial fibrillation (AF) is associated with an increased risk of dementia. However, limited data are available on the predictors of dementia in patients with AF. This study aimed to evaluate whether the CHADS2 score could be a useful tool for risk stratification with regard to dementia occurrence among patients with AF. Methods AF patients were identified from the National Health Insurance sampling database, which has accumulated a total of 1,000,000 participants since 2000. After excluding patients diagnosed with dementia prior to the index day of enrollment, CHADS2 score was measured to investigate its association with the occurrence of dementia, including vascular dementia and Alzheimer's disease. Results During the mean follow-up period of 3.71 ± 2.78 years, 1135 dementia cases (7.36%) were identified, including 241 cases of vascular dementia and 894 cases of Alzheimer's disease. In multivariate analysis, an increase of 1 point in the CHADS2 score was independently associated with a 54% increase in the risk of vascular dementia (hazard ratio = 1.54; 95% confidence interval, 1.41–1.69; p < 0.001) and a 40% increase in Alzheimer's disease (hazard ratio = 1.40; 95% confidence interval, 1.34–1.46; p < 0.001). Conclusion CHADS2 score is a useful predictor for the development of vascular dementia as well as Alzheimer's disease in patients with AF.

KW - Alzheimer's disease

KW - atrial fibrillation

KW - CHADS2 score

KW - dementia

KW - stroke

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