A summary risk score for the prediction of Alzheimer disease in elderly persons.
OBJECTIVE
To develop a simple summary risk score for the prediction of Alzheimer disease in elderly persons based on their vascular risk profiles.


METHODS
A longitudinal, community-based study.


METHODS
New York, New York. Patients One thousand fifty-one Medicare recipients aged 65 years or older and residing in New York who were free of dementia or cognitive impairment at baseline.


METHODS
We separately explored the associations of several vascular risk factors with late-onset Alzheimer disease (LOAD) using Cox proportional hazards models to identify factors that would contribute to the risk score. Then we estimated the score values of each factor based on their beta coefficients and created the LOAD vascular risk score by summing these individual scores.


RESULTS
Risk factors contributing to the risk score were age, sex, education, ethnicity, APOE epsilon4 genotype, history of diabetes, hypertension or smoking, high-density lipoprotein levels, and waist to hip ratio. The resulting risk score predicted dementia well. According to the vascular risk score quintiles, the risk to develop probable LOAD was 1.0 for persons with a score of 0 to 14 and increased 3.7-fold for persons with a score of 15 to 18, 3.6-fold for persons with a score of 19 to 22, 12.6-fold for persons with a score of 23 to 28, and 20.5-fold for persons with a score higher than 28.


CONCLUSIONS
While additional studies in other populations are needed to validate and further develop the score, our study suggests that this vascular risk score could be a valuable tool to identify elderly individuals who might be at risk of LOAD. This risk score could be used to identify persons at risk of LOAD, but can also be used to adjust for confounders in epidemiologic studies.
Reitz
Christiane
C
The Gertrude H. Sergievsky Center, Columbia University, New York, NY 10032, USA. cr2101@columbia.edu
Tang
Ming-Xin
MX
Schupf
Nicole
N
Manly
Jennifer J
JJ
Mayeux
Richard
R
Luchsinger
José A
JA
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000235:genetics; D053327:Apolipoprotein E4 / Q000235:genetics; D003920:Diabetes Mellitus; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D006973:Hypertension; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D009519:New York City; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011569:Psychiatric Status Rating Scales; D012111:Residence Characteristics; D012307:Risk Factors
D053327:Apolipoprotein E4