Tiwari S, et al. - This prospective population study aimed to examine the associations between atrial fibrillation (AF) and cognitive decline, focusing on whether stroke risk factors modulated this association in stroke-free women and men. In stroke-free participants, AF was independently associated with cognitive decline as measured by the tapping test.

• A total of 4983 participants (57% women) were included from the 5th survey of the Tromsø Study (Tromsø 5, 2001), of whom 2491 also participated in 6th survey (Tromsø 6, 2007-08).
• The authors obtained information about age, education, blood pressure, body mass index, lipids, smoking, coffee consumption, physical activity, depression, coronary and valvular heart disease, heart failure and diabetes at baseline.
• AF status was based on hospital records.
• For this study, the outcome was changed in cognitive score from Tromsø 5 to Tromsø 6, measured by the verbal memory test, the digit-symbol coding test, and the tapping test.

• At baseline, mean age was 65.4 years.
• Compared to those without AF (3.8 taps/10 sec, 95% CI 3.5, 4.1), the mean reduction in the tapping test scores was significantly larger in participants with AF (5.3 taps/10 sec, 95% confidence interval (CI) 3.9, 6.7).
• When adjusted for other risk factors, these estimates were unchanged and were similar for both sexes.
• AF was not correlated with change in the digit-symbol coding or the verbal memory tests.