Evidence map›Paper›PMID 38857466›Full record

ArticleNeurology2024

Population Dementia Incidence and Direct Oral Anticoagulant Use in a Representative Population With Atrial Fibrillation.

Johanna Thunell, Kathryn Wood, Whitney Wharton, Geoffrey Joyce, Patricia Ferido, Julie Zissimopoulos

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Observational
  3. Article
  4. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Johanna ThunellFrom the Schaeffer Center for Health Policy and Economics (J.T., G.J., P.F., J.Z.), and Sol Price School of Public Policy (J.T., J.Z., P.F.), University of Southern California, Los Angeles; Woodruff School of Nursing (K.W.), and Department of Neurology (W.W.), School of Medicine, Emory University, Atlanta, GA; and Mann School of Pharmacy (G.J.), University of Southern California.ORCID 0000-0003-3361-4933
Kathryn WoodFrom the Schaeffer Center for Health Policy and Economics (J.T., G.J., P.F., J.Z.), and Sol Price School of Public Policy (J.T., J.Z., P.F.), University of Southern California, Los Angeles; Woodruff School of Nursing (K.W.), and Department of Neurology (W.W.), School of Medicine, Emory University, Atlanta, GA; and Mann School of Pharmacy (G.J.), University of Southern California.
Whitney WhartonFrom the Schaeffer Center for Health Policy and Economics (J.T., G.J., P.F., J.Z.), and Sol Price School of Public Policy (J.T., J.Z., P.F.), University of Southern California, Los Angeles; Woodruff School of Nursing (K.W.), and Department of Neurology (W.W.), School of Medicine, Emory University, Atlanta, GA; and Mann School of Pharmacy (G.J.), University of Southern California.
Geoffrey JoyceFrom the Schaeffer Center for Health Policy and Economics (J.T., G.J., P.F., J.Z.), and Sol Price School of Public Policy (J.T., J.Z., P.F.), University of Southern California, Los Angeles; Woodruff School of Nursing (K.W.), and Department of Neurology (W.W.), School of Medicine, Emory University, Atlanta, GA; and Mann School of Pharmacy (G.J.), University of Southern California.
Patricia FeridoFrom the Schaeffer Center for Health Policy and Economics (J.T., G.J., P.F., J.Z.), and Sol Price School of Public Policy (J.T., J.Z., P.F.), University of Southern California, Los Angeles; Woodruff School of Nursing (K.W.), and Department of Neurology (W.W.), School of Medicine, Emory University, Atlanta, GA; and Mann School of Pharmacy (G.J.), University of Southern California.
Julie ZissimopoulosFrom the Schaeffer Center for Health Policy and Economics (J.T., G.J., P.F., J.Z.), and Sol Price School of Public Policy (J.T., J.Z., P.F.), University of Southern California, Los Angeles; Woodruff School of Nursing (K.W.), and Department of Neurology (W.W.), School of Medicine, Emory University, Atlanta, GA; and Mann School of Pharmacy (G.J.), University of Southern California.

Funding

EXPANDING MHAS RESEARCH INFRASTRUCTURE WITH HISTORICAL CLIMATE AND LIFETIME WORKPLACE ENVIRONMENTAL EXPOSURES INFLUENCING INEQUITIES IN AD/ADRDP30AG066589 · NIA · UNIVERSITY OF SOUTHERN CALIFORNIA · PI DANA P GOLDMAN, JULIE M ZISSIMOPOULOS · 2020 to 2026
$6.1M
NIA NIH HHS P30 AG066589
6 · The paper itself

Abstract

BACKGROUND AND

objectivesIncidence and prevalence of atrial fibrillation (AF), a risk factor of dementia, have been increasing over time. Oral anticoagulation reduces risk of stroke and other negative outcomes of AF and may reduce dementia health inequities. The objective of this study was to estimate dementia incidence in patients with newly-diagnosed AF and taking an anticoagulant as use of direct oral anticoagulants (DOACs) increased.

methodsWe used a retrospective cohort design with annual incident AF cohorts of community-dwelling Medicare Fee-for-Service beneficiaries, enrolled in Parts A, B, and D from 2007 to 2017. The sample was limited to beneficiaries aged 67 years and older with incident AF; no prior dementia; and use of anticoagulants warfarin, dabigatran, rivaroxaban, apixaban, or edoxaban in year

resultsA total of 1,083,338 beneficiaries were included in the study, 58.5% female, with mean (SD) age 77.2 (6.75) years. Among anticoagulated, incident AF cohorts, use of DOACs increased from 10.6% in their first year of availability (2011) to 41.4% in 2017. Among incident AF cohorts taking any oral anticoagulant, 3-year dementia incidence did not change significantly over the cohorts after adjusting for confounders. For example, incidence was 9.1% (95% CI 8.9-9.4) among White persons diagnosed with AF in 2007 and 2008 and 8.9% (95% CI 8.7-9.1) in 2017. Across cohorts, dementia incidence was consistently highest for Black persons, followed by American Indian/Alaska Native and White persons, and lowest for Asian persons. In 2017, 10.9% (95% CI 10.4-11.3) of Black persons in the cohort developed dementia within 3 years, 9.4% (95% CI 8.0-10.9) of American Indian/Alaska Native, 8.9% (95% CI 8.7-9.1) of White, 8.7% (95% CI 8.2-9.1) of Hispanic, and 6.9% (95% CI 6.4-7.4) of Asian persons. Across race/ethnicity, 3-year stroke risk decreased consistently over time; however, the increasing availability of DOACs did not alter the trend. DISCUSSION: Increased use of DOACs among incident AF cohorts from 2007 to 2017 was not associated with significant declines in dementia or stroke risk. Consideration of similar stroke and dementia risk, as well as differences in cost, is warranted when weighing the risks and benefits of available oral anticoagulants.

Indexed as

AnticoagulantsAtrial FibrillationDementiaMedicareAdministration, OralAgedAged, 80 and overCohort StudiesDabigatranFemaleHumansIncidenceMaleRetrospective StudiesRivaroxabanUnited StatesAnticoagulantsDabigatranRivaroxabanWarfarin

Identifiers

PMID38857466
PMCPMC11226323

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.