Association of frontal assessment battery score with clinical outcomes in patients with heart failure and cognitive impairment

Q: What are the key findings of this study?

Low Frontal Assessment Battery performance (≤11 points) was independently associated with a higher risk of all-cause mortality or heart failure readmission (HR 1.915, 95% CI 1.078-3.402; P=0.027).

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Heart failure and cognitive impairment (n=140). Intervention: Low Frontal Assessment Battery (FAB) score (≤ 11 points) vs. High Frontal Assessment Battery (FAB) score (≥ 12 points). Primary outcome: Composite of all-cause mortality or readmission for heart failure (HR 1.915, 95% CI 1.078-3.402, p=0.027).

Q: What does this research mean for the field?

In patients with heart failure and cognitive impairment, low Frontal Assessment Battery performance is independently associated with an increased risk of adverse clinical outcomes, driven primarily by heart failure readmission. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Shinya Takahashi; Tomoyuki Murata; Masaki Ota; Nobuaki Fukuda; Shitoshi Hiroi

doi:10.1186/s12872-026-06928-w

October 26, 2026BMC Cardiovascular DisordersOpen Access

Association of frontal assessment battery score with clinical outcomes in patients with heart failure and cognitive impairment

View Full Paper

Ask AI

Bookmark

Share

Key result

Low FAB score linked to ~92% higher risk of death or heart failure readmission.

HR 1.915
95% CI 1.078-3.402
P=0.027
n=140

Why the study?

Cognitive impairment in patients with heart failure is associated with poor self-care and adverse outcomes, but the association between Frontal Assessment Battery (FAB) performance and clinical outcomes in this population remains unclear.

Does a low Frontal Assessment Battery score (≤11 points) predict a higher risk of all-cause mortality or heart failure readmission compared to a high score (≥12 points) in hospitalized patients with heart failure and cognitive impairment?

Key Points

To investigate the association between Frontal Assessment Battery (FAB) performance and clinical outcomes in patients with heart failure and cognitive impairment.
Single-centre retrospective cohort study screening consecutive patients hospitalised for heart failure between October 2022 and March 2025.
Included 140 patients with cognitive impairment (MoCA-J score ≤ 25; median age, 81 years; 54% men) classified into High-FAB (≥ 12 points, n=85) and Low-FAB (≤ 11 points, n=55) groups, followed for a median of 359 days.
The primary endpoint was a composite of all-cause mortality or readmission for heart failure, evaluated using Kaplan–Meier analysis and multivariable Cox proportional hazards regression.
The composite primary outcome occurred in 67% of the Low-FAB group compared with 28% of the High-FAB group (log-rank P < 0.001), predominantly driven by readmission for heart failure (62% vs. 24%, P < 0.001), whereas all-cause mortality did not differ significantly (5.5% vs. 4.7%, P = 0.843).
After adjustment for age, sex, log-transformed NT-proBNP, and MoCA-J score, Low-FAB status remained independently associated with the composite outcome (HR, 1.915; 95% CI, 1.078–3.402; P = 0.027).

Study Design

Type

Cohort (n=140)

Multicenter

No

Structured PICO

Does a low Frontal Assessment Battery score (≤11 points) predict a higher risk of all-cause mortality or heart failure readmission compared to a high score (≥12 points) in hospitalized patients with heart failure and cognitive impairment?

P

Population

140 elderly patients (median age 81 years, 46% female) hospitalized for heart failure with concomitant cognitive impairment (MoCA-J ≤ 25) and discharged home, followed for a median of 359 days.

E

Exposure

Low Frontal Assessment Battery (Low-FAB) status, defined as a pre-discharge FAB score ≤11 points (n=55)

C

Comparator

High Frontal Assessment Battery (High-FAB) status, defined as a pre-discharge FAB score ≥12 points (n=85)

O

Outcome

Composite of the first occurrence of all-cause mortality or unplanned readmission for worsening heart failure, assessed from discharge over a median follow-up of 359 days (IQR 198-672 days), identified via Diagnosis Procedure Combination (DPC) database and verified by medical record review.composite

Main Result

Hazard Ratio: 1.915 (95% CI 1.078–3.402)

Absolute Event Rate: 67% vs 28%

p-value: p=0.027

Limitations

Retrospective single-centre study with a highly selected population, limiting generalizability
Limited sample size and number of events resulting in imprecise estimates and wide confidence intervals
Potential residual confounding due to unmeasured factors such as frailty, activities of daily living, caregiver support, and self-care behaviors
FAB 11/12 cut-off has not been validated as a prognostic threshold in heart failure, and cognitive testing was performed only once during hospitalization
Relatively low use of contemporary guideline-directed medical therapy such as SGLT2 inhibitors
Retrospective single-centre study with a highly selected population (excluding those unable to complete cognitive testing, NYHA IV, or non-home discharge), limiting generalizability.
Limited sample size and number of events, resulting in imprecise estimates and wide confidence intervals, and non-significant improvement in Harrell's C-index.
Potential residual confounding due to unmeasured variables such as frailty, activities of daily living, sarcopenia, nutritional/psychological status, educational background, caregiver support, and self-care behaviors.
The FAB 11/12 cut-off has not been validated as a prognostic threshold in heart failure, and cognitive testing was performed only once during hospitalization without neuroimaging or repeated post-discharge assessments.
Relatively low use of contemporary guideline-directed medical therapy, particularly SGLT2 inhibitors (32%).

Implication

In older patients hospitalized with heart failure and cognitive impairment, a lower Frontal Assessment Battery score (≤11) independently predicts an increased risk of post-discharge heart failure readmission and mortality even after adjusting for global cognitive function (MoCA-J).

Abstract

Cognitive impairment in patients with heart failure is associated with poor self-care and adverse outcomes. However, the association between Frontal Assessment Battery (FAB) performance and clinical outcomes in this population remains unclear. We investigated the association between FAB score and clinical outcomes in patients with heart failure and cognitive impairment. This was a single-centre retrospective cohort study. We screened consecutive patients hospitalised for heart failure between October 2022 and March 2025. Patients who underwent both MoCA-J and FAB assessments before discharge were considered for inclusion. The analysis was restricted to patients with cognitive impairment, defined as a MoCA-J score of 25 points or lower. The primary endpoint was a composite of all-cause mortality or readmission for heart failure. Among 140 patients with cognitive impairment (median age, 81 years; 54% men; median follow-up, 359 days), 85 were classified as High-FAB (≥ 12 points) and 55 as Low-FAB (≤ 11 points). The Low-FAB group had a significantly higher incidence of the composite outcome than the High-FAB group (log-rank P < 0.001), mainly driven by readmission for heart failure. After adjustment for age, sex, log-transformed NT-proBNP, and MoCA-J score, Low-FAB status remained associated with the composite outcome (hazard ratio, 1.915; 95% confidence interval, 1.078–3.402). In patients with heart failure and cognitive impairment, lower FAB performance was associated with a higher risk of adverse clinical outcomes, particularly readmission for heart failure. Larger prospective studies are needed to confirm these findings.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Takahashi et al. (2026) conducted a cohort in Heart failure and cognitive impairment (n=140). Low Frontal Assessment Battery (FAB) score (≤ 11 points) vs. High Frontal Assessment Battery (FAB) score (≥ 12 points) was evaluated on Composite of all-cause mortality or readmission for heart failure (HR 1.915, 95% CI 1.078-3.402, p=0.027). Low Frontal Assessment Battery performance (≤11 points) was independently associated with a higher risk of all-cause mortality or heart failure readmission (HR 1.915, 95% CI 1.078-3.402; P=0.027).

synapsesocial.com/papers/6ae28f09cbadf70daf6c441b https://doi.org/10.1186/s12872-026-06928-w

View Full Paper

Ask AI

Bookmark

Share

Association of frontal assessment battery score with clinical outcomes in patients with heart failure and cognitive impairment

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Association of frontal assessment battery score with clinical outcomes in patients with heart failure and cognitive impairment

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading