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Posted by on May 14, 2009 in Epidemiology, Neurology, Neuropsychiatry

New Index Predicts Dementia in Late Life

New Index Predicts Dementia in Late Life

A “highly accurate” index to predict the risk of dementia during late life has been developed by investigators in Northern California and Pittsburgh. The scale, which is available in the latest online issue of Neurology, is based on data from more than 3000 community-dwelling adults* (65 years of age) in the Cardiovascular Health Cognition Study and identifies 11 potential risk factors for late-life dementia. 

Points are allotted for the following risk factors, and the tallied score (range, 0-15) can be used to stratify dementia risk among subjects. The accuracy of the index (defined by the c statistic, which is similar to the correlation coefficient) was calculated at 0.81 (95% CI: 0.79, 0.83) and is close to that of a previously published dementia-risk index for middle-aged individuals.

Dementia Risk Factor

Points

Age 75-79 y

1

Age 80-100 y

2

Low Modified MMSE score

2

Low Digit Symbol Substitution Test** Score

2

Body mass index <18.5

2

≥1 APOE ε4 allele

1

MRI: white matter disease (grade ≥3)

1

MRI: enlarged ventricles (grade ≥4)

1

Internal carotid artery thickness ≥2.2 mm

1

History of coronary artery bypass

1

Time to put on and button shirt >45 s

1

Lack of alcohol consumption

1

Among subjects with low scores (0-3), about 4% developed dementia during the next 6 years. Moderate scores (4-7) were associated with a 6-year dementia risk of 23%, and 56% of subjects with high scores (8) developed dementia. Among those subjects who acquired dementia (n = 480 or 14%), 245 had Alzheimer disease, 62 had vascular dementia, 151 had mixed dementia, and 22 had other forms of dementia.

Because some of the identified dementia risk factors may be difficult to determine in routine clinical practice (eg, grading of MRI parameters, APOE ε4 status), the authors are performing additional analyses to determine if a simpler, but equally accurate, index can be generated.

In the meantime, drink upin moderation, of course. Of course

* Mean age at baseline = 75 years; ~60% women, 15% African American.

** A measure of attention and mental-processing speed.

bmartin (1127 Posts)

A native East Tennessean, Barbara Martin is a formerly practicing, board-certified neurologist who received her BS (psychology, summa cum laude) and MD from Duke University before completing her postgraduate training (internship, residency, fellowship) at the Hospital of the University of Pennsylvania in Philadelphia. She has worked in academia, private practice, medical publishing, drug market research, and continuing medical education (CME). For the last 3 years, she has worked in a freelance capacity as a medical writer, analyst, and consultant. Follow Dr. Barbara Martin on and Twitter.