ArticleAge and ageing2023
Comparing the risk of dementia in subjects with atrial fibrillation using non-vitamin K antagonist oral anticoagulants versus vitamin K antagonists: a Belgian nationwide cohort study.
Article in Age and ageing, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Comparative impact of direct oral anticoagulants and vitamin K antagonists on cognitive function in atrial fibrillation patients: a systematic review and meta-analysis.Journal of medicine and life · 2025Pooled it
- Article
- Efficacy of anticoagulation therapy in elderly patients with clinically diagnosed Alzheimer's disease and atrial fibrillation: a clinical outcomes study.Frontiers in cellular neuroscience · 2026Article
- Comorbidity and medication patterns in atrial fibrillation patients: association with adverse clinical outcomes.Internal and emergency medicine · 2025Article
- 2025 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.Circulation · 2025Review
- The role of atrial fibrillation in vascular cognitive impairment and dementia: epidemiology, pathophysiology, and preventive strategies.GeroScience · 2025Review
- Atrial fibrillation and cognitive impairment: mechanisms, influencing factors, and prospects.Frontiers in cardiovascular medicine · 2025Review
- Drug-induced dementia: a real-world pharmacovigilance study using the FDA Adverse Event Reporting System database.Therapeutic advances in neurological disorders · 2025Article
- Dementia risk reduction between DOACs and VKAs in AF: A systematic review and meta-analysis.Journal of arrhythmia · 2024Article
- The effect of oral anticoagulants on the incidence of dementia in patients with atrial fibrillation: A systematic review and meta-analysis.International journal of cardiology. Cardiovascular risk and prevention · 2024Review
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAtrial fibrillation (AF) is associated with cognitive decline, with anticoagulated subjects potentially having a reduced risk compared with non-anticoagulated subjects. However, whether non-vitamin K antagonist oral anticoagulants (NOACs) may reduce the risk of dementia compared with vitamin K antagonists (VKAs) is unclear yet. Therefore, the risk of dementia was compared between AF subjects on NOACs versus VKAs.
methodsAF subjects initiating anticoagulation between 2013 and 2019 were identified in Belgian nationwide data. Inverse probability of treatment weighted Cox regression was used to investigate cognitive outcomes.
resultsAmong 237,012 AF subjects (310,850 person-years (PYs)), NOAC use was associated with a significantly lower risk of dementia (adjusted hazard ratio (aHR) 0.91, 95% confidence interval (CI) (0.85-0.98)) compared with VKAs. A trend towards a lower risk of vascular dementia (aHR 0.89, 95% CI (0.76-1.04)) and significantly lower risk of other/unspecified dementia (aHR 0.91, 95% CI (0.84-0.99)) were observed with NOACs compared with VKAs, whereas the risk of Alzheimer's disease was similar (aHR 0.99, 95% CI (0.88-1.11)). Apixaban (aHR 0.91, 95% CI (0.83-0.99)) and edoxaban (aHR 0.79, 95% CI (0.63-0.99)) were associated with significantly lower risks of dementia compared with VKAs, while risks were not significantly different with dabigatran (aHR 1.02, 95% CI (0.93-1.12)) and rivaroxaban (aHR 0.97, 95% CI (0.90-1.05)). Comparable risks of dementia were observed between individual NOACs, except for significantly lower risks of dementia (aHR 0.93, 95% CI (0.87-0.98)) and other/unspecified dementia (aHR 0.90 (0.84-0.97)) with apixaban compared with rivaroxaban.
conclusionNOACs were associated with a significantly lower risk of dementia compared with VKAs, likely driven by apixaban and edoxaban use.
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