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Predicting risk of dementia in older adults: The late-life dementia risk index.

TitlePredicting risk of dementia in older adults: The late-life dementia risk index.
Publication TypeJournal Article
Year of Publication2009
AuthorsBarnes, DE, Covinsky, KE, Whitmer, RA, Kuller, LH, Lopez, OL, Yaffe, K
JournalNeurology
Volume73
Issue3
Pagination173-9
Date Published2009 Jul 21
ISSN1526-632X
KeywordsAge Factors, Aged, Aged, 80 and over, Alcohol Drinking, Apolipoprotein E4, Body Mass Index, Carotid Stenosis, Cerebrum, Cognition Disorders, Cohort Studies, Coronary Artery Bypass, Dementia, Female, Genetic Markers, Health Status Indicators, Humans, Logistic Models, Male, Predictive Value of Tests, Risk Assessment, Risk Factors, Risk Reduction Behavior
Abstract<p><b>OBJECTIVE: </b>To develop a late-life dementia risk index that can accurately stratify older adults into those with a low, moderate, or high risk of developing dementia within 6 years.</p><p><b>METHODS: </b>Subjects were 3,375 participants in the Cardiovascular Health Cognition Study without evidence of dementia at baseline. We used logistic regression to identify those factors most predictive of developing incident dementia within 6 years and developed a point system based on the logistic regression coefficients.</p><p><b>RESULTS: </b>Subjects had a mean age of 76 years at baseline; 59% were women and 15% were African American. Fourteen percent (n = 480) developed dementia within 6 years. The final late-life dementia risk index included older age (1-2 points), poor cognitive test performance (2-4 points), body mass index <18.5 (2 points), > or =1 apolipoprotein E epsilon4 alleles (1 point), cerebral MRI findings of white matter disease (1 point) or ventricular enlargement (1 point), internal carotid artery thickening on ultrasound (1 point), history of bypass surgery (1 point), slow physical performance (1 point), and lack of alcohol consumption (1 point) (c statistic, 0.81; 95% confidence interval, 0.79-0.83). Four percent of subjects with low scores developed dementia over 6 years compared with 23% of subjects with moderate scores and 56% of subjects with high scores.</p><p><b>CONCLUSIONS: </b>The late-life dementia risk index accurately stratified older adults into those with low, moderate, and high risk of developing dementia. This tool could be used in clinical or research settings to target prevention and intervention strategies toward high-risk individuals.</p>
DOI10.1212/WNL.0b013e3181a81636
Alternate JournalNeurology
PubMed ID19439724
PubMed Central IDPMC2715571
Grant ListAG15928 / AG / NIA NIH HHS / United States
N01-HC-85085 / HC / NHLBI NIH HHS / United States
U01 HL080295 / HL / NHLBI NIH HHS / United States
N01-HC-85081 / HC / NHLBI NIH HHS / United States
R56 AG020098 / AG / NIA NIH HHS / United States
N01-HC-85086 / HC / NHLBI NIH HHS / United States
N01-HC-15103 / HC / NHLBI NIH HHS / United States
K01 AG024069-04 / AG / NIA NIH HHS / United States
N01-HC-85082 / HC / NHLBI NIH HHS / United States
N01-HC-35129 / HC / NHLBI NIH HHS / United States
K01 AG024069 / AG / NIA NIH HHS / United States
N01-HC-55222 / HC / NHLBI NIH HHS / United States
N01-HC-85083 / HC / NHLBI NIH HHS / United States
N01-HC-75150 / HC / NHLBI NIH HHS / United States
N01-HC-85080 / HC / NHLBI NIH HHS / United States
UL1 RR024131 / RR / NCRR NIH HHS / United States
R01 AG020098 / AG / NIA NIH HHS / United States
N01-HC-45133 / HC / NHLBI NIH HHS / United States
N01-HC-85079 / HC / NHLBI NIH HHS / United States
K24 AG029812 / AG / NIA NIH HHS / United States
N01-HC-85084 / HC / NHLBI NIH HHS / United States