Arrhythmias & electrophysiologyCohort study
Arrhythmias, dementia risk, and neurodegeneration: a cohort study
- Prospective cohort study
Authors' conclusion
Incident arrhythmias (both AF and non-AF) exhibit independent and accumulated associations with dementia risk and consistent neurodegeneration.
Study context
- Population
- UK Biobank participants without baseline arrhythmias, dementia or organic central nervous system diseases10,564 (2.70%) dementia
- Participants
- 391,078 participants
- Exposure
- Incident arrhythmia vs no arrhythmia
- Arrhythmia (AR)n = 50,243
- Atrial fibrillation/flutter (AF)n = 33,182
- Brady/Blockn = 21,244
- Ventricular arrhythmia (VA)n = 6,296
- Outcome
- All-cause, vascular and Alzheimer's dementia
- Follow-up
- Median 13.35 years
Main finding
As reported in the abstract
- Incident AR, AF, Brady/Block and VA independently associated with increased risk of all dementia outcomes (fully adjusted Model 3)
- Accumulated arrhythmia exposure: positive dose-response with dementia risk, driven largely by AF+Brady/Block
- Concurrent AF and atrioventricular block (AVB)/sinus node dysfunction (SND) (or bundle branch block (BBB)): higher dementia risk than either exposure alone
- Pacemaker implantation: lower risk than AVB/SND without pacing
- fully adjusted Model 3
- robust to incident stroke or cardiac arrest, genetic dementia risk, baseline cognition, and sensitivity analyses
Observational data: associations, not effects.
Further findings
Incremental predictive value beyond conventional risk factors
- Non-AF arrhythmias provided incremental predictive value, similar to AF
Brain magnetic resonance imaging (MRI)
- Arrhythmia-related neurodegenerative changes: brain atrophy, choroid-plexus enlargement, white-matter injury
Original publication
Arrhythmias, dementia risk, and neurodegeneration: a cohort study. Eur Heart J. Published 27 May 2026. doi:10.1093/eurheartj/ehag401
Summarised from the published abstract; every number is checked against it