Table 2. Association of Left Atrial Measures With Incident Dementia: Atherosclerosis Risk in Communities Study, 2011-2019 (N = 4096).
| No. incident dementia/No. at risk | Incidence rate, per 100 person-yearsa | Incidence rate difference (95% CI), per 100 person-yearsa | Hazard ratio (95% CI)b | ||||
|---|---|---|---|---|---|---|---|
| Model 1 | Model 2 | Model 3 | |||||
| LA reservoir strain, % | |||||||
| ≤26.72 | 190/819 | 4.80 | 3.25 (2.48 to 4.01) | 2.09 (1.58 to 2.76) | 2.00 (1.51 to 2.64) | 1.98 (1.42 to 2.75) | |
| 26.73-30.59 | 102/820 | 2.09 | 0.54 (0.01 to 1.07) | 1.02 (0.76 to 1.38) | 1.00 (0.74 to 1.34) | 1.01 (0.74 to 1.38) | |
| 30.60-34.41 | 86/819 | 1.72 | 0.17 (−0.33 to 0.67) | 0.93 (0.68 to 1.26) | 0.92 (0.67 to 1.25) | 0.94 (0.68 to 1.28) | |
| 34.42-39.40 | 74/819 | 1.46 | −0.09 (−0.57 to 0.39) | 0.87 (0.63 to 1.20) | 0.86 (0.63 to 1.19) | 0.87 (0.63 to 1.20) | |
| ≥39.41 | 79/819 | 1.55 | [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | |
| LA conduit strain, % | |||||||
| ≤9.90 | 167/819 | 3.94 | 2.66 (1.99 to 3.33) | 1.81 (1.34 to 2.44) | 1.75 (1.30 to 2.37) | 1.50 (1.09 to 2.06) | |
| 9.91-13.06 | 120/817 | 2.57 | 1.29 (0.73 to 1.84) | 1.45 (1.07 to 1.97) | 1.39 (1.02 to 1.89) | 1.29 (0.94 to 1.77) | |
| 13.07-15.89 | 89/821 | 1.82 | 0.54 (0.06 to 1.03) | 1.13 (0.82 to 1.56) | 1.12 (0.81 to 1.55) | 1.08 (0.78 to 1.49) | |
| 15.90-19.52 | 89/820 | 1.77 | 0.49 (0.01 to 0.97) | 1.19 (0.87 to 1.64) | 1.19 (0.86 to 1.64) | 1.17 (0.85 to 1.61) | |
| ≥19.53 | 66/819 | 1.28 | [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | |
| LA contractile strain, % | |||||||
| ≤13.47 | 143/819 | 3.29 | 1.49 (0.83 to 2.14) | 1.75 (1.33 to 2.30) | 1.70 (1.29 to 2.23) | 1.57 (1.16 to 2.14) | |
| 13.48-16.62 | 104/819 | 2.14 | 0.34 (−0.21 to 0.90) | 1.15 (0.86 to 1.53) | 1.09 (0.82 to 1.45) | 1.06 (0.79 to 1.42) | |
| 16.63-19.17 | 95/819 | 1.96 | 0.16 (−0.38 to 0.70) | 1.11 (0.83 to 1.48) | 1.11 (0.83 to 1.49) | 1.07 (0.80 to 1.44) | |
| 19.18-22.37 | 100/821 | 2.00 | 0.20 (−0.34 to 0.74) | 1.14 (0.85 to 1.52) | 1.12 (0.84 to 1.49) | 1.09 (0.82 to 1.46) | |
| ≥22.38 | 89/818 | 1.80 | [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | |
| LA emptying fraction, % | |||||||
| ≤50.92 | 176/819 | 4.20 | 2.70 (1.99 to 3.40) | 1.87 (1.42 to 2.47) | 1.78 (1.34 to 2.36) | 1.87 (1.31 to 2.65) | |
| 50.93-56.58 | 111/819 | 2.32 | 0.82 (0.28 to 1.37) | 1.19 (0.88 to 1.59) | 1.17 (0.87 to 1.58) | 1.20 (0.87 to 1.66) | |
| 56.59-61.28 | 91/820 | 1.83 | 0.33 (−0.17 to 0.84) | 1.08 (0.79 to 1.47) | 1.07 (0.79 to 1.46) | 1.09 (0.80 to 1.50) | |
| 61.29-66.17 | 77/819 | 1.55 | 0.05 (−0.43 to 0.54) | 1.01 (0.74 to 1.39) | 1.01 (0.73 to 1.38) | 1.01 (0.74 to 1.40) | |
| ≥66.18 | 76/819 | 1.50 | [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | |
| LA passive emptying fraction, % | |||||||
| ≤17.63 | 161/819 | 3.67 | 2.18 (1.52 to 2.84) | 1.49 (1.12 to 1.98) | 1.45 (1.09 to 1.92) | 1.26 (0.93 to 1.71) | |
| 17.64-23.66 | 97/819 | 2.06 | 0.57 (0.05 to 1.10) | 1.04 (0.76 to 1.41) | 1.04 (0.76 to 1.41) | 0.97 (0.71 to 1.33) | |
| 23.67-28.68 | 110/820 | 2.27 | 0.78 (0.25 to 1.33) | 1.23 (0.91 to 1.65) | 1.22 (0.91 to 1.64) | 1.15 (0.85 to 1.56) | |
| 28.69-35.20 | 87/819 | 1.77 | 0.28 (−0.22 to 0.78) | 1.04 (0.76 to 1.41) | 1.05 (0.77 to 1.43) | 1.03 (0.75 to 1.40) | |
| >35.20 | 76/819 | 1.49 | [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | |
| LA active emptying fraction, % | |||||||
| ≤35.15 | 145/819 | 3.27 | 1.53 (0.89 to 2.18) | 1.56 (1.19 to 2.05) | 1.50 (1.14 to 1.97) | 1.43 (1.04 to 1.96) | |
| 35.16-41.05 | 108/819 | 2.28 | 0.54 (−0.02 to 1.11) | 1.23 (0.92 to 1.64) | 1.18 (0.88 to 1.57) | 1.12 (0.83 to 1.51) | |
| 41.06-46.07 | 105/820 | 2.11 | 0.37 (−0.17 to 0.92) | 1.09 (0.82 to 1.45) | 1.08 (0.81 to 1.45) | 1.04 (0.77 to 1.40) | |
| 46.09-51.88 | 87/819 | 1.78 | 0.04 (−0.48 to 0.57) | 0.99 (0.73 to 1.34) | 0.99 (0.74 to 1.34) | 0.99 (0.73 to 1.33) | |
| ≥51.89 | 86/819 | 1.74 | [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | |
| Maximal LA volume index, mL/m2 | |||||||
| ≤24.69 | 103/819 | 2.12 | [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | |
| 24.70-29.77 | 88/819 | 1.80 | −0.32 (−0.87 to 0.24) | 0.75 (0.56 to 0.99) | 0.77 (0.57 to 1.02) | 0.74 (0.55 to 0.99) | |
| 29.78-34.85 | 96/820 | 1.96 | −0.16 (−0.72 to 0.41) | 0.79 (0.59 to 1.04) | 0.81 (0.61 to 1.07) | 0.76 (0.57 to 1.01) | |
| 34.86-41.65 | 100/819 | 2.07 | −0.05 (−0.62 to 0.53) | 0.78 (0.59 to 1.04) | 0.79 (0.59 to 1.04) | 0.71 (0.53 to 0.94) | |
| ≥41.66 | 144/819 | 3.18 | 1.06 (0.40 to 1.73) | 0.98 (0.75 to 1.28) | 0.94 (0.72 to 1.24) | 0.77 (0.58 to 1.02) | |
| Minimal LA volume index, mL/m2 | |||||||
| ≤8.96 | 88/819 | 1.76 | [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | |
| 8.97-11.61 | 78/819 | 1.59 | −0.17 (−0.68 to 0.35) | 0.87 (0.64 to 1.17) | 0.89 (0.65 to 1.20) | 0.86 (0.63 to 1.16) | |
| 11.62-14.56 | 92/820 | 1.86 | 0.10 (−0.43 to 0.63) | 0.85 (0.63 to 1.14) | 0.87 (0.64 to 1.17) | 0.82 (0.61 to 1.10) | |
| 14.57-19.00 | 121/819 | 2.52 | 0.76 (0.18 to 1.35) | 1.07 (0.81 to 1.42) | 1.09 (0.82 to 1.44) | 0.98 (0.74 to 1.30) | |
| ≥19.01 | 152/819 | 3.50 | 1.76 (1.07 to 2.40) | 1.23 (0.93 to 1.63) | 1.17 (0.89 to 1.55) | 0.95 (0.71 to 1.28) | |
Abbreviations: APOE, apolipoprotein E; BMI, body mass index; LA, left atrial.
a
Incidence rates are unadjusted.
b
Model 1 was adjusted for age, sex, race and center, APOE ɛ4, education, BMI, smoking status, diabetes, systolic blood pressure, coronary heart disease, heart failure, antihypertensive medications, and anticoagulant use; model 2, model 1 plus incident atrial fibrillation and incident stroke; and model 3, model 2 plus minimal LA volume index, left ventricular ejection fraction, and left ventricular mass index.