| Title: | Arrhythmias, dementia risk, and neurodegeneration: a cohort study |
| Journal: | European Heart Journal |
| Published: | 27 May 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/42200489/ |
| DOI: | https://doi.org/10.1093/eurheartj/ehag401 |
Publication 19903
WARNING: the interactive features of this website use CSS3, which your browser does not support. To use the full features of this website, please update your browser.
Abstract
BACKGROUND AND AIMS: Evidence linking arrhythmias to dementia predominantly focuses on atrial fibrillation/flutter (AF), leaving non-AF subtypes under-researched. This study investigated associations of multiple incident and accumulated arrhythmia exposures with dementia and brain magnetic resonance imaging (MRI) to address these gaps.</p>
METHODS: UK Biobank participants without baseline arrhythmias, dementia, or organic central nervous system diseases were included. Cox models estimated associations of incident arrhythmia (AR), AF, bradyarrhythmia/conduction block (Brady/Block), ventricular arrhythmia (VA), and accumulated arrhythmia exposure (types) with all-cause, vascular and Alzheimer's dementia. Specific subtypes-including atrioventricular block (AVB), sinus node dysfunction (SND), and bundle branch block (BBB)-were also evaluated. Arrhythmia-related brain MRI alterations were analysed.</p>
RESULTS: Among 391 078 participants (median follow-up 13.35 years), 50 243 (12.85%) developed incident AR (AF, n = 33 182; Brady/Block, n = 21 244; VA, n = 6296), and 10 564 (2.70%) developed all-cause dementia (vascular, n = 2034; Alzheimer, n = 4329). Incident AR, AF, Brady/Block, and VA were independently associated with increased risk of all dementia outcomes (fully adjusted Model 3). Accumulated arrhythmia exposure exhibited a positive dose-response relationship with dementia risk, driven largely by AF+Brady/Block. Concurrent AF and AVB/SND (or BBB) showed higher dementia risk than either exposure alone, whereas pacemaker implantation related to lower risk than AVB/SND without pacing. These associations remained robust to incident stroke or cardiac arrest, genetic dementia risk, baseline cognition, and sensitivity analyses. Non-AF arrhythmias provided incremental predictive value beyond conventional risk factors, similar to AF. Brain MRI analysis revealed arrhythmia-related neurodegenerative changes, including brain atrophy, choroid-plexus enlargement, and white-matter injury.</p>
CONCLUSIONS: Incident arrhythmias (both AF and non-AF) exhibit independent and accumulated associations with dementia risk and consistent neurodegeneration. These findings extend the arrhythmia-dementia association beyond AF and suggest multi-arrhythmic framework for dementia risk assessment.</p>
11 Authors
- Wenzhao Lu
- Sixian Weng
- Yutong Wang
- Jiawei Zhang
- Jiachen Niu
- Ran Xiong
- Zhuo Liang
- Tao Zhang
- Geng Shen
- Pingzhen Yang
- Yunlong Wang
1 Application
| Application ID | Title |
|---|---|
| 177024 | The influence of genotype, biomarkers, lifestyle, and psychosocial factors on the occurrence, development, and prognosis of cardiovascular diseases, to establish an early risk prediction model. |
Enabling scientific discoveries that improve human health