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Exercise and the Risk of Dementia in Patients with Newly Diagnosed Atrial Fibrillation: A Nationwide Population-Based Study

Background: It is unclear whether exercise would reduce dementia in patients with a new diagnosis of atrial fibrillation (AF). Therefore, we aimed to evaluate the association between the change in physical activity (PA) before and after new-onset AF and the risk of incident dementia. Methods: Using...

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Autores principales: Lim, Jaehyun, Lee, So-Ryoung, Choi, Eue-Keun, Han, Kyung-Do, Jung, Jin-Hyung, Ahn, Hyo-Jeong, Yun, Jun Pil, Kwon, Soonil, Oh, Seil, Lip, Gregory Y. H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8304225/
https://www.ncbi.nlm.nih.gov/pubmed/34300292
http://dx.doi.org/10.3390/jcm10143126
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author Lim, Jaehyun
Lee, So-Ryoung
Choi, Eue-Keun
Han, Kyung-Do
Jung, Jin-Hyung
Ahn, Hyo-Jeong
Yun, Jun Pil
Kwon, Soonil
Oh, Seil
Lip, Gregory Y. H.
author_facet Lim, Jaehyun
Lee, So-Ryoung
Choi, Eue-Keun
Han, Kyung-Do
Jung, Jin-Hyung
Ahn, Hyo-Jeong
Yun, Jun Pil
Kwon, Soonil
Oh, Seil
Lip, Gregory Y. H.
author_sort Lim, Jaehyun
collection PubMed
description Background: It is unclear whether exercise would reduce dementia in patients with a new diagnosis of atrial fibrillation (AF). Therefore, we aimed to evaluate the association between the change in physical activity (PA) before and after new-onset AF and the risk of incident dementia. Methods: Using the Korean National Health Insurance Service database, we enrolled a total of 126,555 patients with newly diagnosed AF between 2010 and 2016, who underwent health examinations within two years before and after their diagnosis of AF. The patients were divided into four groups: persistent non-exercisers, exercise starters, exercise quitters, and exercise maintainers. Results: Based on a total of 396,503 person-years of follow-up, 5943 patients were diagnosed with dementia. Compared to persistent non-exercisers, exercise starters (adjusted hazard ratio (aHR) 0.87; 95% confidence interval (CI) 0.81–0.94), and exercise maintainers (aHR 0.66; 95% CI 0.61–0.72) showed a lower risk of incident dementia; however, the risk was similar in exercise quitters (aHR 0.98; 95% CI 0.92–1.05) (p-trend < 0.001). There was a J-shaped relationship between the dose of exercise and the risk of dementia, with the risk reduction maximized at 5–6 times per week of moderate-to-vigorous PA among exercise starters. Conclusion: Patients who initiated or continued regular exercise after diagnosis of AF were associated with a lower risk of dementia than persistent non-exercisers, with no risk reduction associated with exercise cessation. Our findings may provide evidence for the benefit of exercise prescription to patients with new-onset AF to prevent incident dementia regardless of their current exercise status.
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spelling pubmed-83042252021-07-25 Exercise and the Risk of Dementia in Patients with Newly Diagnosed Atrial Fibrillation: A Nationwide Population-Based Study Lim, Jaehyun Lee, So-Ryoung Choi, Eue-Keun Han, Kyung-Do Jung, Jin-Hyung Ahn, Hyo-Jeong Yun, Jun Pil Kwon, Soonil Oh, Seil Lip, Gregory Y. H. J Clin Med Article Background: It is unclear whether exercise would reduce dementia in patients with a new diagnosis of atrial fibrillation (AF). Therefore, we aimed to evaluate the association between the change in physical activity (PA) before and after new-onset AF and the risk of incident dementia. Methods: Using the Korean National Health Insurance Service database, we enrolled a total of 126,555 patients with newly diagnosed AF between 2010 and 2016, who underwent health examinations within two years before and after their diagnosis of AF. The patients were divided into four groups: persistent non-exercisers, exercise starters, exercise quitters, and exercise maintainers. Results: Based on a total of 396,503 person-years of follow-up, 5943 patients were diagnosed with dementia. Compared to persistent non-exercisers, exercise starters (adjusted hazard ratio (aHR) 0.87; 95% confidence interval (CI) 0.81–0.94), and exercise maintainers (aHR 0.66; 95% CI 0.61–0.72) showed a lower risk of incident dementia; however, the risk was similar in exercise quitters (aHR 0.98; 95% CI 0.92–1.05) (p-trend < 0.001). There was a J-shaped relationship between the dose of exercise and the risk of dementia, with the risk reduction maximized at 5–6 times per week of moderate-to-vigorous PA among exercise starters. Conclusion: Patients who initiated or continued regular exercise after diagnosis of AF were associated with a lower risk of dementia than persistent non-exercisers, with no risk reduction associated with exercise cessation. Our findings may provide evidence for the benefit of exercise prescription to patients with new-onset AF to prevent incident dementia regardless of their current exercise status. MDPI 2021-07-15 /pmc/articles/PMC8304225/ /pubmed/34300292 http://dx.doi.org/10.3390/jcm10143126 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lim, Jaehyun
Lee, So-Ryoung
Choi, Eue-Keun
Han, Kyung-Do
Jung, Jin-Hyung
Ahn, Hyo-Jeong
Yun, Jun Pil
Kwon, Soonil
Oh, Seil
Lip, Gregory Y. H.
Exercise and the Risk of Dementia in Patients with Newly Diagnosed Atrial Fibrillation: A Nationwide Population-Based Study
title Exercise and the Risk of Dementia in Patients with Newly Diagnosed Atrial Fibrillation: A Nationwide Population-Based Study
title_full Exercise and the Risk of Dementia in Patients with Newly Diagnosed Atrial Fibrillation: A Nationwide Population-Based Study
title_fullStr Exercise and the Risk of Dementia in Patients with Newly Diagnosed Atrial Fibrillation: A Nationwide Population-Based Study
title_full_unstemmed Exercise and the Risk of Dementia in Patients with Newly Diagnosed Atrial Fibrillation: A Nationwide Population-Based Study
title_short Exercise and the Risk of Dementia in Patients with Newly Diagnosed Atrial Fibrillation: A Nationwide Population-Based Study
title_sort exercise and the risk of dementia in patients with newly diagnosed atrial fibrillation: a nationwide population-based study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8304225/
https://www.ncbi.nlm.nih.gov/pubmed/34300292
http://dx.doi.org/10.3390/jcm10143126
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