FDRS variables predict Alzheimer's disease, dementia in heart failure, atrial fibrillation patients

Variables from the Framingham Heart Study Dementia Risk Score (FDRS) are predictive of Alzheimer’s disease (AD) and AD-related dementias (ADRD) in patients with heart failure (HF) or atrial fibrillation (AF), a study has shown.

“The addition of comorbidities and risk factors only modestly improved prediction, indicating that the FDRS variables are appropriate to predict AD/ADRD in patients with HF and AF,” the authors said.

In this study, the authors identified residents aged ≥50 years from seven southeastern Minnesota counties in the US with a first diagnosis of HF or AF between 1 January 2013 and 31 December 2017. They excluded patients with AD/ADRD before or within 6 months after index AF or HF and those who died within 6 months following index.

Models were created for both cohorts to predict AD/ADRD after index, including variables in the FDRS. Comorbidities and risk factors were also added to the models. Finally, the authors calculated c-statistics using fivefold cross-validation for all models.

Of the 3,052 HF patients (mean age, 75 years, 53 percent male), 626 developed AD/ADRD, while 736 out of 4,107 AF patients (mean age 74 years, 57 percent male) developed AD/ADRD. In the HF cohort, the FDRS variables predicted AD/ADRD (c-statistic, 0.69). The addition of comorbidities and risk factors to the model slightly improved the c-statistic to 0.70.

Likewise, the FDRS variables predicted AD/ADRD in the AF cohort (c-statistic, 0.73), and the addition of comorbidities and risk factors slightly improved the c-statistic to 0.75.

“The FDRS was developed in a general population of older persons,” the authors said.