Abstract P2097: Association of atrial fibrillation with probable dementia in the SPRINT Trial

Background: Emerging evidence suggests that atrial fibrillation (AF) is associated with cognitive impairment and dementia, though the extent of this relationship in certain populations remains unclear. Methods: We examined the association of baseline AF and incident probable dementia (PD) in patients with hypertension but without diabetes or a history of stroke who were enrolled in the Systolic Blood Pressure Intervention Trial (SPRINT). Incident mild cognitive impairment (MCI) and a composite of PD and MCI were also used as outcomes in additional analyses. Participants with prevalent PD or MCI at baseline were excluded. Baseline AF was detected from electrocardiograms (ECGs) read centrally at an ECG core, and cognitive outcomes were ascertained during follow-up by an adjudication committee. Results: Among the 8,027 participants (mean age 67.9, women 36.5%) included in the analysis, 106 (1.3%) had AF at baseline. During a median follow-up of 5.0 years, 306 (3.8%) incident PD events occurred. Participants with baseline AF had a higher incidence of PD than those without AF (8.5% vs. 3.7%, p-value = 0.01) In a multivariable Cox regression model adjusted for socio-demographics, treatment assignment, cardiovascular risk factors, and potential confounders, participants with baseline AF were at a higher risk of incident PD and the composite of MCI/PD, but not incident MCI. (Table) . Conclusion: In individuals with hypertension but without diabetes or a history of stroke, AF is associated with an increased risk of probable dementia. Further studies are needed to investigate whether AF screening and management might positively impact brain health.