Association between primary care electrocardiogram markers and Alzheimer's disease

Isaksen, Jonas L. and Ghouse, Jonas and Skov, Morten W. and Olsen, Morten S. and Holst, Anders G. and Pietersen, Adrian and Nielsen, Jonas B. and Maier, Anja and Graff, Claus and Gerds, Thomas A and Frikke-Schmidt, Ruth and Kanters, Jørgen K. (2023) Association between primary care electrocardiogram markers and Alzheimer's disease. Journal of the Neurological Sciences, 447. 120581. ISSN 0022-510X (https://doi.org/10.1016/j.jns.2023.120581)

[thumbnail of Isaksen-etal-JNS-2023-Association-between-primary-care-electrocardiogram-markers-and-Alzheimers-disease]
Preview
 Text. Filename: Isaksen_etal_JNS_2023_Association_between_primary_care_electrocardiogram_markers_and_Alzheimers_disease.pdf
Accepted Author Manuscript
License: Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 logo
Download (697kB)| Preview

Abstract

Objective -- The association between common electrocardiogram (ECG) markers and Alzheimer's disease has been scarcely investigated, and it is unknown if ECG markers can improve risk prediction. Thus, we aimed to examine the association between common ECG markers and Alzheimer's disease in a large population. Methods -- We studied the association between ECG markers and Alzheimer's disease using Cox models with adjustment for age, sex, and comorbidities using a large primary care population of patients aged 60 years or more. Results -- We followed 172,236 subjects for a median of 7.5 years. Increased PR interval (hazard ratio for PR > 188 ms: 0.76 [95% confidence interval: 0.69–0.83, p 35 mm (1.22 [1.13–1.33], p 4.1 mm (1.15 [1.04–1.27]) were associated with an increased rate of Alzheimer's disease. Upon addition of ECG markers to a reference model, 10-year prediction area under the receiver-operator characteristics curve (AUC) improved by 0.39 [0.06–0.67] %-points. The 10-year absolute risk of Alzheimer's disease was 6.5% and 5.2% for an 82-year old female and a male, respectively, with a favorable ECG, and 12% and 9.2%, respectively, with an unfavorable ECG, almost twice as high. Conclusions -- We identified several common ECG markers which were associated with Alzheimer's disease, and which improved risk prediction for Alzheimer's disease.

CORE (COnnecting REpositories)