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Atrial fibrillation in the elderly general population: a 30-year follow-up from 70 to 100 years of age

Journal article
Authors Gustaf Lernfelt
Zacharias Mandalenakis
Björn Hornestam
Bodil Lernfelt
Annika Rosengren
Valter Sundh
Per-Olof Hansson
Published in Scandinavian Cardiovascular Journal
Pages 7
ISSN 1401-7431
Publication year 2020
Published at Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
Institute of Medicine, Department of Molecular and Clinical Medicine
Pages 7
Language en
Keywords Atrial fibrillation, incidence, prevalence, mortality, all-cause mortality, risk-factors, stroke mortality, natural-history, ischemic-stroke, heart-failure, lifetime risk, epidemiology, prevalence, management, Cardiovascular System & Cardiology
Subject categories Cardiac and Cardiovascular Systems


Objectives. There is limited knowledge of atrial fibrillation (AF) incidence among the very old. Data from longitudinal cohort studies may give us a better insight. The aim of the study was to investigate the incidence rate and prevalence of AF, as well as the impact of AF on mortality, in the general population, from 70 to 100 years of age. Design. This was a population-based prospective cohort study where three representative samples of 70-year-old men and women (n = 2,629) from the Gerontological and Geriatric Populations Studies in Gothenburg (H-70) were included between 1971 and 1982. The participants were examined at age 70 years and were re-examined repeatedly until 100 years of age. AF was diagnosed according to a 12-lead electrocardiogram (ECG) recording at baseline and follow-up examinations, from the Swedish National Patient Register (NPR), or from the Cause of Death Register. Results. The cumulative incidence of AF from 70 to 100 years of age was 65.6% for men and 52.8% for women. Mortality was significantly higher in participants with AF compared with those without, rate ratio (RR) 1.92 (95% CI 1.73-2.14). In a subgroup analysis comprising only participants with AF diagnosed by ECG at screening, the RR for death was 1.29 (95% C.I: 1.03-1.63). Conclusions. Among persons surviving to age 70, the cumulative incidence of AF was over 50% during follow-up. Mortality rate was twice as high in participants with AF compared to participants without AF. Among participants with AF first recorded at a screening examination, the increased risk was only 29%.

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