Atrial Fibrillation and Longitudinal Change in Cognitive Function in CKD

Mark D McCauley; Jesse Y Hsu; Ana C Ricardo; Dawood Darbar; Mayank Kansal; Manjula Kurella Tamura; Harold I Feldman; John W Kusek; Jonathan J Taliercio; Panduranga S Rao; Tariq Shafi; Jiang He; Xue Wang; Daohang Sha; Melissa Lamar; Alan S Go; Kristine Yaffe; James P Lash; CRIC Study Investigators

doi:10.1016/j.ekir.2020.12.023

Atrial Fibrillation and Longitudinal Change in Cognitive Function in CKD

Kidney Int Rep. 2021 Jan 5;6(3):669-674. doi: 10.1016/j.ekir.2020.12.023. eCollection 2021 Mar.

Authors

Mark D McCauley^{1

2}, Jesse Y Hsu³, Ana C Ricardo¹, Dawood Darbar^{1

2}, Mayank Kansal^{1

2}, Manjula Kurella Tamura^{4

5}, Harold I Feldman^{3

4}, John W Kusek^{3

4}, Jonathan J Taliercio⁶, Panduranga S Rao⁷, Tariq Shafi⁸, Jiang He⁹, Xue Wang^{3

4}, Daohang Sha³, Melissa Lamar¹⁰, Alan S Go^{11

12

13

14}, Kristine Yaffe¹⁵, James P Lash¹; CRIC Study Investigators

Collaborators

CRIC Study Investigators:
Lawrence J Appel, Mahboob Rahman, Raymond R Townsend

Affiliations

¹ Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA.
² Jesse Brown VA Medical Center, Chicago, Illinois, USA.
³ Center for Clinical Epidemiology & Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁴ Departments of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Philadelphia, Pennsylvania, USA.
⁵ Department of Medicine, Stanford University, Palo Alto, California, USA.
⁶ Department of Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
⁷ Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA.
⁸ Department of Medicine, University of Mississippi, Jackson, Mississippi, USA.
⁹ Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA.
¹⁰ Rush Alzheimer's Disease Center and the Department of Psychiatry and Behavioral Sciences, Rush University, Chicago, Illinois, USA.
¹¹ Division of Research, Kaiser Permanente Northern California, Oakland, California, USA.
¹² Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA.
¹³ Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
¹⁴ Departments of Medicine, Health Research and Policy, Stanford University, Stanford, California, USA.
¹⁵ Departments of Psychiatry and Neurology, University of California, San Francisco, San Francisco, California, USA.

Abstract

Background: Studies in the general population suggest that atrial fibrillation (AF) is an independent risk factor for decline in cognitive function, but this relationship has not been examined in adults with chronic kidney disease (CKD). We investigated the association between incident AF and changes in cognitive function over time in this population.

Methods and results: We studied a subgroup of 3254 adults participating in the Chronic Renal Insufficiency Cohort Study. Incident AF was ascertained by 12-lead electrocardiogram (ECG) obtained at a study visit and/or identification of a hospitalization with AF during follow-up. Cognitive function was assessed biennially using the Modified Mini-Mental State Exam. Linear mixed effects regression was used to evaluate the association between incident AF and longitudinal change in cognitive function. Compared with individuals without incident AF (n = 3158), those with incident AF (n = 96) were older, had a higher prevalence of cardiovascular disease and hypertension, and lower estimated glomerular filtration rate. After median follow-up of 6.8 years, we observed no significant multivariable association between incident AF and change in cognitive function test score.

Conclusion: In this cohort of adults with CKD, incident AF was not associated with a decline in cognitive function.

Keywords: atrial fibrillation; cognitive function; nephrology and kidney.

Abstract

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