title: Predicting Risk of Cognitive Decline in Very Old Adults Using Three Models: The Framingham Stroke Risk Profile; the Cardiovascular Risk Factors, Aging, and Dementia Model; and Oxi-Inflammatory Biomarkers.
abstract: OBJECTIVE
  To examine the Framingham Stroke Risk Profile (FSRP); the Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) risk score, and oxi-inflammatory load (cumulative risk score of three blood biomarkers-homocysteine, interleukin-6, C-reactive protein) for associations with cognitive decline using three cohort studies of very old adults and to examine whether incorporating these biomarkers with the risk scores can affect the association with cognitive decline.
  
  
  METHODS
  Three longitudinal, population-based cohort studies.
  
  
  METHODS
  Newcastle-upon-Tyne, United Kingdom; Leiden, the Netherlands; and Lakes and Bay of Plenty District Health Board areas, New Zealand.
  
  
  METHODS
  Newcastle 85+ Study participants (n = 616), Leiden 85-plus Study participants (n = 444), and Life and Living in Advanced Age, a Cohort Study in New Zealand (LiLACS NZ Study) participants (n = 396).
  
  
  METHODS
  FSRP, CAIDE risk score, oxi-inflammatory load, FSRP incorporating oxi-inflammatory load, and CAIDE risk score incorporating oxi-inflammatory load. Oxi-inflammatory load could be calculated only in the Newcastle 85+ and the Leiden 85-plus studies. Measures of global cognitive function were available for all three data sets. Domain-specific measures were available for the Newcastle 85+ and the Leiden 85-plus studies.
  
  
  RESULTS
  Meta-analysis of pooled results showed greater risk of incident global cognitive impairment with higher FSRP (hazard ratio (HR) = 1.46, 95% confidence interval (CI) = 1.08-1.98), CAIDE (HR = 1.53, 95% CI = 1.09-2.14), and oxi-inflammatory load (HR = 1.73, 95% CI = 1.04-2.88) scores. Adding oxi-inflammatory load to the risk scores increased the risk of cognitive impairment for the FSRP (HR = 1.65, 95% CI = 1.17-2.33) and the CAIDE model (HR = 1.93, 95% CI = 1.39-2.67).
  
  
  CONCLUSIONS
  Adding oxi-inflammatory load to cardiovascular risk scores may be useful for determining risk of cognitive impairment in very old adults.
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Harrison
authors.affiliation: Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Anton J M
authors.initials: AJ
authors.lastname: de Craen
authors.affiliation: Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, Auckland, New Zealand.
authors.forename: Ngaire
authors.initials: N
authors.lastname: Kerse
authors.affiliation: Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, Auckland, New Zealand.
authors.forename: Ruth
authors.initials: R
authors.lastname: Teh
authors.affiliation: Institute of Ageing, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom.|Ageing, Geriatrics and Epidemiology, Institute of Neuroscience, National Institute for Health Research Newcastle Biomedical Research Centre in Ageing and Chronic Disease, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.
authors.forename: Antoneta
authors.initials: A
authors.lastname: Granic
authors.affiliation: Institute of Ageing, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom.|Ageing, Geriatrics and Epidemiology, Institute of Neuroscience, National Institute for Health Research Newcastle Biomedical Research Centre in Ageing and Chronic Disease, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.
authors.forename: Karen
authors.initials: K
authors.lastname: Davies
authors.affiliation: Wesnes Cognition Ltd, Streatley on Thames, United Kingdom.|Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom.
authors.forename: Keith A
authors.initials: KA
authors.lastname: Wesnes
authors.affiliation: Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, The Netherlands.|Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Wendy P J
authors.initials: WP
authors.lastname: den Elzen
authors.affiliation: Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Jacobijn
authors.initials: J
authors.lastname: Gussekloo
authors.affiliation: Institute of Cell and Molecular Biosciences, Institute of Ageing, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors.forename: Thomas B L
authors.initials: TB
authors.lastname: Kirkwood
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom.|Institute of Ageing, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors.forename: Louise
authors.initials: L
authors.lastname: Robinson
authors.affiliation: Institute of Ageing, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors.forename: Carol
authors.initials: C
authors.lastname: Jagger
authors.affiliation: Institute of Ageing, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom.|Institute of Cellular Medicine, Institute of Ageing, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors.forename: Mario
authors.initials: M
authors.lastname: Siervo
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom.|Institute of Ageing, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors.forename: Blossom C M
authors.initials: BC
authors.lastname: Stephan
mesh_terms: D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D060825:Cognitive Dysfunction / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D006710:Homocysteine / Q000097:blood; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D016016:Proportional Hazards Models; D018570:Risk Assessment / Q000379:methods*
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D006710:Homocysteine; D002097:C-Reactive Protein
keywords: biomarkers; cardiovascular risk; cognitive decline; cognitive function; dementia