| Title: |
Fazekas score predicts cognitive decline & frailty in older adults: insights from the SAGE-AF cohort study |
| Authors: |
Srichawla, Bahadar S; Barbini, Melanie K; Lessard, Darleen; Saczynski, Jane S; McManus, David D; Moonis, Majaz |
| Contributors: |
Biostatistics and Health Services Research; Population and Quantitative Health Sciences; Neurobiology; Neurology; Medicine |
| Source: |
Neurological research and practice ; 7 ; 1 ; 78 ; England |
| Publication Year: |
2025 |
| Collection: |
University of Massachusetts, Medical School: eScholarship@UMMS |
| Subject Terms: |
Cognitive decline; Dementia; Fazekas score; Frailty; MoCA; Small vessel disease |
| Description: |
Background: Atrial fibrillation (AF) is a common condition in older adults, often associated with increased risks of cognitive decline and frailty. White matter hyperintensities (WMH), visible on neuroimaging and quantified by the Fazekas score, have been linked to both cognitive and physical impairments. However, the relationship between WMH, cognitive decline, and frailty in older adults with AF remains relatively underexplored. Methods: This study analyzed data from 86 participants in the SAGE-AF cohort, a two-year prospective multicenter cohort study of older adults with AF, who also had neuroimaging performed for clinical indications. WMH severity was assessed by independent reviewers using Fazekas scores from brain imaging. Cognitive function was measured using the Montreal Cognitive Assessment (MoCA), and frailty was assessed at baseline as well as 1- and 2-year follow-up visits by trained examiners as part of the SAGE-AF study protocol. Participants were characterized based on the severity of their white matter hyperintensities and compared to baseline and two-year cognitive and physical functional status. Longitudinal regression models were used to adjust for demographic, clinical, and geriatric covariates. Results: Participants with higher Fazekas scores (grades 2-3) demonstrated significantly lower baseline and follow-up MoCA scores and were more likely to meet frailty criteria over a two-year follow-up period. After adjusting for multiple factors known to influence cognitive decline, greater white matter hyperintensity (Fazekas grades 2-3) remained associated with a 2.6-fold increased risk of cognitive impairment at (p = 0.04) and a 2.7-fold increased risk of frailty at (p = 0.02). Conclusion: Higher Fazekas scores are related to cognitive decline and frailty in older adults with AF, emphasizing WMH as a critical biomarker for aging-related impairments. Neuroimaging tools like Fazekas scoring could enhance risk stratification and inform targeted interventions for this vulnerable population. ; No ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
Neurological Research and Practice; https://doi.org/10.1186/s42466-025-00439-3; https://hdl.handle.net/20.500.14038/54878 |
| DOI: |
10.1186/s42466-025-00439-3 |
| Availability: |
https://doi.org/10.1186/s42466-025-00439-3; https://hdl.handle.net/20.500.14038/54878 |
| Rights: |
© The Author(s) 2025. Open Access: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. ; http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.CE8D8DE1 |
| Database: |
BASE |