ArticleNeurological research and practice2025
Fazekas score predicts cognitive decline & frailty in older adults: insights from the SAGE-AF cohort study.
Article in Neurological research and practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Article
- Impact of brain frailty on language recovery in patients with acute post-stroke aphasia: a post-hoc analysis of the LEXI randomized controlled trial.Neurological research and practice · 2026Article
- Clinical and Inflammatory Predictors of Neurocognitive Decline in Long COVID: A Two-Year Longitudinal Study with Propensity Score Matching.Medicina (Kaunas, Lithuania) · 2026Observational
- Analysis of Predictive Factors for Cognitive Function Improvement After tDCS Treatment in Patients With Post-stroke Cognitive Impairment.Actas espanolas de psiquiatria · 2026Article
- The Role of Leukoaraiosis and Microbleeds in Acute Ischemic Stroke Outcome Prediction.Journal of clinical medicine · 2026Article
- Glymphatic dysfunction and its association with clinical symptom severity in narcolepsy type 1: a case-control DTI-ALPS study.BMC neurology · 2026Article
- A simplified Fazekas scale for efficient assessment of white matter hyperintensities.Frontiers in neurology · 2026Article
- From scavenger to victim: mechanism and treatment of microglial ferroptosis in white matter injury disease.Frontiers in immunology · 2026Review
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6 authors.
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Abstract
backgroundAtrial 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.
methodsThis 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.
resultsParticipants 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).
conclusionHigher 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.
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