Rawtaer Iris, Feng Lei, Yuen Vanessa Hew Kuan, Li Jialiang, Chong Mei Sian, Lim Wee Shiong, Lee Tih-Shih, Qiu Chengxuan, Feng Liang, Kua Ee Heok, Ng Tze Pin
Department of Psychological Medicine, National University Hospital, Singapore, Singapore.
Dement Geriatr Cogn Disord. 2016;41(5-6):348-58. doi: 10.1159/000447448. Epub 2016 Jul 20.
Several risk scores have been developed for predicting cognitive impairment and dementia, but none have been validated in Asian samples. We aimed to produce a risk score that best predicts incident neurocognitive disorder (NCD) among Chinese elderly and to validate this score against the modified risk score derived from the Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study.
Data from participants enrolled in the Singapore Longitudinal Ageing Study (SLAS) 1 were analyzed. A total of 957 participants >55 years of age with normal cognition at baseline were included. Incident cases of NCD were measured using the global Clinical Dementia Rating (CDR) and determined by a consensus panel.
The best prediction model from SLAS included age, gender, education, depression, heart disease, social and productive activities and Mini-Mental State Examination score. This model predicted the short-term risk of incident NCD in elderly participants moderately well, with a C statistic (area under the curve) of 0.72. Modified CAIDE models applied to our sample had a C statistic of 0.71.
Our risk score performs as well as other available risk scores. It is the only risk score formulated for ethnic Chinese, rendering it valuable for clinical use in Asia; at-risk individuals can be identified for early intervention.
已经开发了几种用于预测认知障碍和痴呆症的风险评分，但没有一种在亚洲样本中得到验证。我们旨在生成一种能最好地预测中国老年人新发神经认知障碍（NCD）的风险评分，并将该评分与源自心血管危险因素、衰老和痴呆（CAIDE）研究的改良风险评分进行验证。
对新加坡纵向衰老研究（SLAS）1中纳入的参与者数据进行分析。共纳入957名年龄>55岁且基线认知正常的参与者。使用全球临床痴呆评定量表（CDR）测量NCD的新发病例，并由一个共识小组确定。
SLAS的最佳预测模型包括年龄、性别、教育程度、抑郁、心脏病、社交和生产活动以及简易精神状态检查评分。该模型对老年参与者新发NCD的短期风险预测效果中等，C统计量（曲线下面积）为0.72。应用于我们样本的改良CAIDE模型的C统计量为0.71。
我们的风险评分与其他现有风险评分表现相当。它是唯一为华裔制定的风险评分，使其在亚洲临床应用中具有价值；可以识别出有风险的个体以便进行早期干预。
