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J Am Heart Assoc. 2022;11(7):e023739.

Low Risk of Dementia in Patients With Newly Diagnosed Atrial Fibrillation and a Clustering of Healthy Lifestyle Behaviors: A Nationwide Population-Based Cohort Study.

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제1저자 박상현, 이소령 · 교신저자 최의근

소속 (6)
  1. Department of Internal Medicine Seoul National University Hospital Seoul Republic of Korea.
  2. Department of Internal Medicine Seoul National University College of Medicine Seoul Republic of Korea.
  3. Department of Medical Statistics College of Medicine Catholic University of Korea Seoul Republic of Korea.
  4. Statistics and Actuarial Science Soongsil University Seoul Republic of Korea.
  5. Liverpool Centre for Cardiovascular Science University of Liverpool and Liverpool Chest and Heart Hospital Liverpool United Kingdom.
  6. Department of Clinical Medicine Aalborg University Aalborg Denmark.

Abstract

Background Limited data are available on the clinical impact of healthy lifestyle behaviors on the risk of dementia in patients with new-onset atrial fibrillation (AF). Here, we aimed to evaluate the association between a combination of healthy lifestyle behaviors and the risk of incident dementia in patients with AF. Methods and Results Using the Korean National Health Insurance database between 2009 and 2016, we identified 199 952 adult patients who were newly diagnosed as AF without dementia. Patients were categorized into 4 groups by healthy lifestyle behavior score (HLS) with 1 point each being assigned for no current smoking, alcohol abstinence, and regular exercise. The HLS 0, 1, 2, and 3 groups included 4.4%, 17.4%, 53.4%, and 24.8% of the patients, respectively. We performed an inverse probability of treatment weighting to balance covariates between HLS groups. The HLS 1, 2, and 3 groups were associated with a lower risk of dementia compared with the HLS 0 group (hazard ratio [HR], 0.769; 95% CI, 0.704-0.842 for HLS 1; HR, 0.770; 95% CI, 0.709-0.836 for HLS 2; and HR, 0.622; 95% CI, 0.569-0.679 for HLS 3). The risk of dementia showed a tendency to decrease with an increase in HLS (P-for-trend <0.001). Conclusions A clustering of healthy lifestyle behaviors was associated with a significantly lower risk of dementia in patients with new-onset AF. These findings support the promotion of a healthy lifestyle within an integrated care approach to AF patient management.

Keywords

atrial fibrillationdementiahealthy lifestyle behaviors

Figures

Figure 1
Figure 1 Flowchart of the study population and follow‐up. Healthy lifestyle behavior score was calculated by assigning 1 point each for no current smoking, abstaining from alcohol, and performing regular exercise. AF indicates atrial fibrillation.
Figure 2
Figure 2 Weighted Kaplan‒Meier curves for incident dementia by healthy lifestyle behavior score. The healthy lifestyle behavior score groups 1, 2, and 3 showed a lower incidence rate of dementia than the healthy lifestyle behavior score 0 group. (A) All dementia. (B) Alzheimer dementia. (C) Vascular dementia. HLS indicates healthy lifestyle behavior score.
Figure 3
Figure 3 Risk of primary and secondary outcomes by healthy lifestyle behavior score: an inverse probability of treatment weighting analysis. Healthy lifestyle behavior score was calculated by assigning 1 point each for no current smoking, abstaining from alcohol, and performing regular exercise. Lines indicate 95% confidential interval; bars, indication of hazard ratio 1.0; and dots, hazard ratio. HR indicates hazard ratio; IPTW, inverse probability of treatment weighting; IR, incidence rate; and PY, person‐years.

그림 출처: PubMed Central 공개 논문 (PMC9075438)

그 밖의 정보
출판 형태
Journal Article, Research Support, Non-U.S. Gov't
저널
Journal of the American Heart Association · eISSN 2047-9980
전자 출판
2022-03-24
MeSH
Adult · Atrial Fibrillation* / complications / diagnosis / epidemiology · Cluster Analysis · Cohort Studies · Dementia* / diagnosis / epidemiology · Healthy Lifestyle · Humans · Risk Factors
참고문헌
65편