title: The BIOCARD Index: A Summary Measure to Predict Onset of Mild Cognitive Impairment.
abstract: BACKGROUND
  Changes in neuropsychological testing, neuroimaging, and cerebrospinal fluid may precede mild cognitive impairment (MCI). However, these markers are not routinely performed in outpatient clinical visits.
  
  
  OBJECTIVE
  To evaluate whether a simple clinical index, consisting of questions given to patients and their informants, could predict the onset of symptoms of MCI among cognitively normal individuals.
  
  
  METHODS
  Two hundred twenty-two participants in the BIOCARD study received a detailed history, physical examination, and neuropsychological testing annually. An index was calculated by including questions about memory problems, depression, age, education, history of cerebrovascular disease risk factors, and brain injury, family history of dementia, and the Mini-Mental State examination score. Cox regression analyses were used to determine if this index score was related to diagnosis of MCI.
  
  
  RESULTS
  The BIOCARD Index score mean for individuals who progressed to MCI was 20.3 (SD=2.9), whereas the score for individuals who remained normal was 24.8 (SD=2.3) (P<0.001) [hazard ratio, SE for subsequent diagnosis of MCI=0.75 (0.67 to 0.84); P<0.001].
  
  
  CONCLUSIONS
  Lower BIOCARD Index score predicted symptoms of MCI several years before the MCI diagnosis. The BIOCARD Index can be easily used in clinics to identify cognitively normal older individuals who are at risk for deterioration.
authors.affiliation: *Department of Neurology, Johns Hopkins Bayview Medical Center †Department of Medicine, Johns Hopkins University School of Medicine ‡Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD §Department of Neurology, Georgetown Medical School, Washington, DC.
authors.forename: Ned
authors.initials: N
authors.lastname: Sacktor
authors.forename: Anja
authors.initials: A
authors.lastname: Soldan
authors.forename: Maura
authors.initials: M
authors.lastname: Grega
authors.forename: Leonie
authors.initials: L
authors.lastname: Farrington
authors.forename: Qing
authors.initials: Q
authors.lastname: Cai
authors.forename: Mei-Cheng
authors.initials: MC
authors.lastname: Wang
authors.forename: Rebecca F
authors.initials: RF
authors.lastname: Gottesman
authors.forename: Raymond S
authors.initials: RS
authors.lastname: Turner
authors.forename: Marilyn
authors.initials: M
authors.lastname: Albert
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000134:cerebrospinal fluid; D060825:Cognitive Dysfunction / Q000175:diagnosis*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers