title: Risk score for the prediction of dementia risk in 20 years among middle aged people: a longitudinal, population-based study.
abstract: BACKGROUND
  Several vascular risk factors are associated with dementia. We sought to develop a simple method for the prediction of the risk of late-life dementia in people of middle age on the basis of their risk profiles.
  
  
  METHODS
  Data were used from the population-based CAIDE study, which included 1409 individuals who were studied in midlife and re-examined 20 years later for signs of dementia. Several midlife vascular risk factors were studied to create the scoring tool. The score values were estimated on the basis of beta coefficients and the dementia risk score was the sum of these individual scores (range 0-15).
  
  
  RESULTS
  Occurrence of dementia during the 20 years of follow-up was 4%. Future dementia was significantly predicted by high age (> or = 47 years), low education (< 10 years), hypertension, hypercholesterolaemia, and obesity. The dementia risk score predicted dementia well (area under curve 0.77; 95% CI 0.71-0.83). The risk of dementia according to the categories of the dementia risk score was 1.0% for those with a score of 0-5, 1.9% for a score of 6-7, 4.2% for a score of 8-9, 7.4% for a score of 10-11, and 16.4% for a score of 12-15. When the cut-off of 9 points or more was applied the sensitivity was 0.77, the specificity was 0.63, and the negative predictive value was 0.98.
  
  
  CONCLUSIONS
  The dementia risk score is a novel approach for the prediction of dementia risk, but should be validated and further improved to increase its predictive value. This approach highlights the role of vascular factors in the development of dementia and could help to identify individuals who might benefit from intensive lifestyle consultations and pharmacological interventions.
authors.affiliation: Aging Research Center, Karolinska Institutet, Stockholm, Sweden. miia.kivipelto@ki.se
authors.forename: Miia
authors.initials: M
authors.lastname: Kivipelto
authors.forename: Tiia
authors.initials: T
authors.lastname: Ngandu
authors.forename: Tiina
authors.initials: T
authors.lastname: Laatikainen
authors.forename: Bengt
authors.initials: B
authors.lastname: Winblad
authors.forename: Hilkka
authors.initials: H
authors.lastname: Soininen
authors.forename: Jaakko
authors.initials: J
authors.lastname: Tuomilehto
mesh_terms: D019540:Area Under Curve; D003704:Dementia / Q000209:etiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D018570:Risk Assessment; D012307:Risk Factors