Year: 2023
Type: article
Abstract: BACKGROUND: Alzheimer's disease (AD) and related dementia (ADRD) risk is affected by multiple dependent risk factors; however, there is no consensus about their relative impact in the development of these disorders. OBJECTIVE: To rank the effects of potentially dependent risk factors and identify an optimal parsimonious set of measures for predicting AD/ADRD risk from a larger pool of potentially correlated predictors. METHODS: We used diagnosis record, survey, and genetic data from the Health and Retirement Study to assess the relative predictive strength of AD/ADRD risk factors spanning several domains: comorbidities, demographics/socioeconomics, health-related behavior, genetics, and environmental exposure. A modified stepwise-AIC-best-subset blanket algorithm was then used to select an optimal set of predictors. RESULTS: The final predictive model was reduced to 10 features for AD and 19 for ADRD; concordance statistics were about 0.85 for one-year and 0.70 for ten-year follow-up. Depression, arterial hypertension, traumatic brain injury, cerebrovascular diseases, and the APOE4 proxy SNP rs769449 had the strongest individual associations with AD/ADRD risk. AD/ADRD risk-related co-morbidities provide predictive power on par with key genetic vulnerabilities. CONCLUSION: Results confirm the consensus that circulatory diseases are the main comorbidities associated with AD/ADRD risk and show that clinical diagnosis records outperform comparable self-reported measures in predicting AD/ADRD risk. Model construction algorithms combined with modern data allows researchers to conserve power (especially in the study of disparities where disadvantaged groups are often grossly underrepresented) while accounting for a high proportion of AD/ADRD-risk-related population heterogeneity stemming from multiple domains.
Source: Journal of Alzheimer s Disease
DOI: 10.3233/jad-221292
Institutions: Duke University, Duke Medical Center
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Awards: EVALUATING EFFECTS IN THE RELATIONSHIP BETWEEN TRAUMATIC BRAIN INJURY AND ALZHEIMERS DISEASE EPIDEMIOLOGICAL DETERMINANTS, G271331228, G3199364579, G3562427435, G4119534169, Racial and Geographic Disparities in Risk and Survival of Alzheimer's Disease and Related Dementias, Determinants of geographic disparities in mortality and multimorbidity in the U.S., Leveraging population-based human data to uncover mechanisms connecting Alzheimer's disease and common infections and facilitate vaccines repurposing for AD prevention
OpenAlex ID: W4387503962