Atrial Fibrillation is Associated With Greater Risk of Dementia in Older Veterans

Am J Geriatr Psychiatry. 2021 Nov;29(11):1092-1098. doi: 10.1016/j.jagp.2021.02.038. Epub 2021 Feb 9.


Objectives: To examine the association of atrial fibrillation (AF) with incident dementia in older veterans and the effect of anticoagulation on that association.

Methods: Around 407,871 veterans aged ≥55 years receiving care from US Veterans Health Administration between August 2003 and September 2015 were included in our retrospective study. AF and incident dementia were determined according to ICD-9-CM codes. Logistic regressions with veterans grouped into high-dimensional propensity scores deciles were used, and a mediation analysis was employed to examine the extent of cardio/cerebrovascular diseases that may also account for that association.

Results: AF was associated with greater dementia risk (odds ratio = 1.14; 95% confidence interval 1.07-1.22), partially mediated by cardio/cerebrovascular disease. Among veterans with AF taking anticoagulants, the risk of dementia was 44% higher (odds ratio =1.44; 95% CI 1.27-1.63) compared to those without anticoagulants, likely related to AF severity.

Conclusion: Our findings underscore the importance of considering cognitive function in the management of AF patients.

Keywords: Atrial fibrillation; anticoagulation; dementia; epidemiology.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Anticoagulants
  • Atrial Fibrillation* / complications
  • Atrial Fibrillation* / epidemiology
  • Dementia* / epidemiology
  • Humans
  • Retrospective Studies
  • Risk Factors
  • Stroke*
  • Veterans*


  • Anticoagulants