O1–02–06: A midlife risk score for the prediction of dementia more than three decades later
Year: 2007
Type: article
Study design: Observational Study
Abstract: Recent work from the CAIDE study has illustrated that a risk score based on age, education, hypertension, obesity, & hyperlipidemia in midlife predicts 20 year dementia risk (area under curve [AUC] = 0.77). Yet the CAIDE midlife dementia risk score has not been tested in larger diverse populations. Our goal was to determine whether dementia prediction could be improved by inclusion of additional midlife risk factors and to validate the CAIDE risk score in a large (N=9831) diverse (20% Non-Caucasian) population of members of an integrated health care delivery system. Population-based Kaiser Permanente (KP) multiphasic health study which started in 1964 and included a comprehensive clinical exam. Participants were those aged 40–55 at midlife exam, and remained members of KP until onset of dementia ascertainment. Alzheimer Disease and Vascular Dementia diagnoses were collected from inpatient and outpatient records from January 1, 1994-January 16, 2006. Age, education, followup time, midlife obesity, hyperlipidemia, and hypertension were used to validate the CAIDE risk score, based on cutpoints and scoring previously developed by the CAIDE study (score values were estimated based on beta-coefficients, and the score was composed as the sum of the individual scores [range 0–14]). We additionally considered midlife diabetes, central obesity, depression and pulmonary function to examine whether these variables further improved the predictability of the risk score. 1038 (10.6%) participants were diagnosed with either Alzheimer disease or Vascular Dementia. Validation of the CAIDE score showed a similar AUC of .74 for the sample overall, and by race; .81 for Asians, .75 for African-Americans and .74 for Caucasians. Addition of midlife status of diabetes, central obesity, depression, pulmonary function and diastolic blood pressure to the risk score improved the predictability for Asians (AUC increased to .84) but not for African-Americans or Caucasians. The probability of dementia according to the categories of risk score was 8% for a score of 0–5; 12% for 6–7; 14% for 8–9; 14.5% for 10–11; and 15% for 12+. A combination of mostly modifiable risk factors in midlife is highly predictive of the likelihood of developing dementia more than three decades later.
Source: Alzheimer s & Dementia
Institutions: Kaiser Permanente, University of California, San Francisco
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W1974288894