title: Predicting cognitive decline: a dementia risk score vs. the Framingham vascular risk scores.
abstract: OBJECTIVE
  Our aim was to compare 2 Framingham vascular risk scores with a dementia risk score in relation to 10-year cognitive decline in late middle age.
  
  
  METHODS
  Participants were men and women with mean age of 55.6 years at baseline, from the Whitehall II study, a longitudinal British cohort study. We compared the Framingham general cardiovascular disease risk score and the Framingham stroke risk score with the cardiovascular risk factors, aging and dementia (CAIDE) risk score that uses risk factors in midlife to estimate risk of late-life dementia. Cognitive tests included reasoning, memory, verbal fluency, vocabulary, and global cognition, assessed 3 times over 10 years.
  
  
  RESULTS
  Higher cardiovascular disease risk and higher stroke risk were associated with greater cognitive decline in all tests except memory; higher dementia risk was associated with greater decline in reasoning, vocabulary, and global cognitive scores. Compared with the dementia risk score, cardiovascular and stroke risk scores showed slightly stronger associations with 10-year cognitive decline; these differences were statistically significant for semantic fluency and global cognitive scores. For example, cardiovascular disease risk was associated with -0.06 SD (95% confidence interval [CI] = -0.08, -0.05) decline in the global cognitive scores over 10 years whereas dementia risk was associated with -0.03 SD (95% CI = -0.04, -0.01) decline (difference in β coefficients = 0.03; 95% CI = 0.01, 0.05).
  
  
  CONCLUSIONS
  The CAIDE dementia and Framingham risk scores predict cognitive decline in late middle age but the Framingham risk scores may have an advantage over the dementia risk score for use in primary prevention for assessing risk of cognitive decline and targeting of modifiable risk factors.
authors.affiliation: INSERM, U1018, Centre for Research in Epidemiology and Population Health, Villejuif; Université de Versailles St. Quentin, France. sara.kaffashian@inserm.fr
authors.forename: Sara
authors.initials: S
authors.lastname: Kaffashian
authors.forename: Aline
authors.initials: A
authors.lastname: Dugravot
authors.forename: Alexis
authors.initials: A
authors.lastname: Elbaz
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Shipley
authors.forename: Séverine
authors.initials: S
authors.lastname: Sabia
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimäki
authors.forename: Archana
authors.initials: A
authors.lastname: Singh-Manoux
mesh_terms: D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D003704:Dementia / Q000150:complications* / Q000523:psychology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D012307:Risk Factors; D012720:Severity of Illness Index
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