Oral anticoagulant use and incident dementia in atrial fibrillation by baseline LIBRA score: a population-based cohort study using the 45 and up study.
Direct oral anticoagulants use linked to lower dementia risk than non-use in atrial fibrillation
Oral anticoagulant use and incident dementia in atrial fibrillation by baseline LIBRA score: a population-based cohort study using the 45 and up study.
Oral anticoagulants (oral anticoagulants), particularly direct oral anticoagulants (direct oral anticoagulants), may lower dementia risk, but existing studies are constrained by incomplete dementia ascertainment, short follow-up, and lack of evaluation of individual agents or baseline lifestyle-related risk profiles.
In this population-based cohort using linked 45 and Up Study data, participants with a first atrial fibrillation diagnosis between 1 January 2010 and 30 June 2022 were included, excluding those with prior atrial fibrillation or dementia (screened 2004-2009).
Direct oral anticoagulants use cut dementia risk by roughly a third versus not using an anticoagulant
Individual direct oral anticoagulants agents were each associated with reduced dementia risk compared with non-use.
Findings were consistent across propensity score-matched, competing-risk, and high-adherence sensitivity analyses.
However, there was no statistically significant evidence that the association differed across LIBRA strata (P for interaction = 0.699) or ORBIT bleeding risk categories (P for interaction = 0.069), suggesting no clear effect modification by either score.
In people with atrial fibrillation, use of direct oral anticoagulants was associated with a reduced risk of incident dementia and dementia-related mortality, independent of baseline LIBRA score.
These findings suggest potential cognitive benefits of direct oral anticoagulants therapy across diverse baseline dementia risk profiles.