To investigate the association between atrial fibrillation (AF) and cerebral small vessel disease (CSVD) markers in older adults, with a particular focus on sex-specific patterns, anticoagulation status, and predictive modeling.
Key Findings:
9.2% of participants had AF, associated with higher WMH volumes (p = 0.051), indicating a trend towards significance.
AF increased odds of symptomatic stroke (OR: 4.2, 95% CI: 2.0–8.8) and larger infarcts.
Frontal lobe CMBs were more prevalent in men with AF (OR: 3.9, p = 0.049).
Predictive models showed high accuracy for WMH burden (81.2%, AUC-ROC: 0.88) and stroke risk (84.9%, AUC-ROC: 0.91).
Interpretation:
AF is independently associated with CSVD, particularly in men and those on anticoagulation therapy, indicating a need for targeted strategies to mitigate AF-related brain injury and improve clinical outcomes.
Limitations:
Cross-sectional design limits causal inference and may affect the interpretation of associations.
Potential selection bias due to exclusion criteria.
Generalizability may be limited to specific populations.
Conclusion:
The study highlights the significant relationship between AF and CSVD markers, emphasizing the importance of understanding sex-specific patterns and the role of anticoagulation in managing brain health in older adults, warranting further research.
