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


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Department of Psychiatry, University of California, San Francisco, CA 94121, USA. Deborah.Barnes@ucsf.edu
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Barnes
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Covinsky
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Whitmer
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Kuller
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Lopez
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Yaffe
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D053327:Apolipoprotein E4 / Q000235:genetics; D015992:Body Mass Index; D016893:Carotid Stenosis / Q000453:epidemiology; D054022:Cerebrum / Q000473:pathology / Q000503:physiopathology; D003072:Cognition Disorders / Q000453:epidemiology; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects; D003704:Dementia / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D005819:Genetic Markers / Q000235:genetics; D006305:Health Status Indicators; D006801:Humans; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D040242:Risk Reduction Behavior
D053327:Apolipoprotein E4; D005819:Genetic Markers