Cadogan SL, Powell E, Wing K, et al. - Prescribing direct oral anticoagulants (DOACs) for new atrial fibrillation (AF) was associated with less common incident EHR(electronic health record)-recorded dementia and mild cognitive impairment (MCI), vs prescribing vitamin K antagonists (VKAs).

• In this historical cohort study of first-time oral anticoagulant users with incident non-valvular AF diagnosed from 2012 to 2018, EHR data were used.

• 39,200 first-time oral anticoagulant users were identified; 20,687 (53%) were prescribed a VKA and 18,513 (47%) a DOAC at baseline.

• GP-recorded incident dementia was evident in 1,258 patients (3.2%), incidence rate 16.5 per 1,000 person-years.

• DOAC prescribed to treat AF resulted in a 16% decrease in dementia diagnosis vs VKA treatment in the entire cohort (adjusted HR 0.84) and afforded a 26% decrease in incident MCI (adjusted HR 0.74).

• Similar results were seen across various sensitivity analyses.