Association between new‐onset atrial fibrillation and dementia among individuals with type 2 diabetes

Abstract Aim To assess the association between new‐onset atrial fibrillation and dementia among patients with type 2 diabetes, a group with a high prevalence of atrial fibrillation. Materials and Methods This cohort study included 22 989 patients with type 2 diabetes from the UK Biobank. New‐onset atrial fibrillation was ascertained from hospital admission records. We used an algorithm officially released by the UK Biobank to identify all‐cause dementia, Alzheimer's disease and vascular dementia. The algorithm was developed using multiple sources, including hospital admissions and the death registry. Time‐varying Cox regression analyses were performed to investigate the association between new‐onset atrial fibrillation and dementia. Results A total of 2843 participants developed atrial fibrillation, whereas the remaining 20 146 did not. During the median of 12.3 years of follow‐up, 844 all‐cause dementia, 342 Alzheimer's disease and 246 vascular dementia cases occurred. Compared with participants without atrial fibrillation, those with atrial fibrillation had higher risks of all‐cause dementia (hazard ratio [HR] 2.15, 95% confidence interval [CI] 1.80‐2.57), Alzheimer's disease (HR 1.44, 95% CI 1.06‐1.96) and vascular dementia (HR 3.11, 95% CI 2.32‐4.17). Conclusions New‐onset atrial fibrillation was associated with a substantially higher risk of all‐cause dementia, Alzheimer's disease and vascular dementia in patients with type 2 diabetes. Our findings highlight the significance of atrial fibrillation management in mitigating the risk of dementia in this demographic.