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A self-report risk index to predict occurrence of dementia in three independent cohorts of older adults: the ANU-ADRI.

TitleA self-report risk index to predict occurrence of dementia in three independent cohorts of older adults: the ANU-ADRI.
Publication TypeJournal Article
Year of Publication2014
AuthorsAnstey, KJ, Cherbuin, N, Herath, PM, Qiu, C, Kuller, LH, Lopez, OL, Wilson, RS, Fratiglioni, L
JournalPLoS One
Volume9
Issue1
Paginatione86141
Date Published2014
ISSN1932-6203
KeywordsAdult, Aged, Aged, 80 and over, Alzheimer Disease, Dementia, Female, Humans, Incidence, Male, Middle Aged, Risk, ROC Curve, Self Report
Abstract<p><b>BACKGROUND AND AIMS: </b>The Australian National University AD Risk Index (ANU-ADRI, http://anuadri.anu.edu.au) is a self-report risk index developed using an evidence-based medicine approach to measure risk of Alzheimer's disease (AD). We aimed to evaluate the extent to which the ANU-ADRI can predict the risk of AD in older adults and to compare the ANU-ADRI to the dementia risk index developed from the Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study for middle-aged cohorts.</p><p><b>METHODS: </b>This study included three validation cohorts, i.e., the Rush Memory and Aging Study (MAP) (n = 903, age ≥53 years), the Kungsholmen Project (KP) (n = 905, age ≥75 years), and the Cardiovascular Health Cognition Study (CVHS) (n = 2496, age ≥65 years) that were each followed for dementia. Baseline data were collected on exposure to the 15 risk factors included in the ANU-ADRI of which MAP had 10, KP had 8 and CVHS had 9. Risk scores and C-statistics were computed for individual participants for the ANU-ADRI and the CAIDE index.</p><p><b>RESULTS: </b>For the ANU-ADRI using available data, the MAP study c-statistic was 0·637 (95% CI 0·596-0·678), for the KP study it was 0·740 (0·712-0·768) and for the CVHS it was 0·733 (0·691-0·776) for predicting AD. When a common set of risk and protective factors were used c-statistics were 0.689 (95% CI 0.650-0.727), 0.666 (0.628-0.704) and 0.734 (0.707-0.761) for MAP, KP and CVHS respectively. Results for CAIDE ranged from c-statistics of 0.488 (0.427-0.554) to 0.595 (0.565-0.625).</p><p><b>CONCLUSION: </b>A composite risk score derived from the ANU-ADRI weights including 8-10 risk or protective factors is a valid, self-report tool to identify those at risk of AD and dementia. The accuracy can be further improved in studies including more risk factors and younger cohorts with long-term follow-up.</p>
DOI10.1371/journal.pone.0086141
Alternate JournalPLoS One
PubMed ID24465922
PubMed Central IDPMC3900468
Grant ListR01 AG017917 / AG / NIA NIH HHS / United States
ePub date: 
12/01