A/P Tze Pin Ng, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Level 9, NUHS Tower Block, 1E Kent Ridge Road, Singapore 119228, Fax: 65-67772191, Email:
J Prev Alzheimers Dis. 2021;8(3):335-344. doi: 10.14283/jpad.2021.19.
Mild cognitive impairment (MCI) is a critical pre-dementia target for preventive interventions. There are few brief screening tools based on self-reported personal lifestyle and health-related information for predicting MCI that have been validated for their generalizability and utility in primary care and community settings.
To develop and validate a MCI risk prediction index, and evaluate its field application in a pilot community intervention trial project.
Two independent population-based cohorts in the Singapore Longitudinal Ageing Study (SLAS). We used SLAS1 as a development cohort to construct the risk assessment instrument, and SLA2 as a validation cohort to verify its generalizability.
community-based screening and lifestyle intervention Participants: (1) SLAS1 cognitively normal (CN) aged ≥55 years with average 3 years (N=1601); (2) SLAS2 cohort (N=3051) with average 4 years of follow up. (3) 437 participants in a pilot community intervention project.
The risk index indicators included age, female sex, years of schooling, hearing loss, depression, life satisfaction, number of cardio-metabolic risk factors (wide waist circumference, pre-diabetes or diabetes, hypertension, dyslipidemia). Weighted summed scores predicted probabilities of MCI or dementia. A self-administered questionnaire field version of the risk index was deployed in the pilot community project and evaluated using pre-intervention baseline cognitive function of participants.
Risk scores were associated with increasing probabilities of progression to MCI-or-dementia in the development cohort (AUC=0.73) and with increased prevalence and incidence of MCI-or-dementia in the validation cohort (AUC=0.74). The field questionnaire risk index identified high risk individuals with strong correlation with RBANS cognitive scores in the community program (p<0.001).
The SLAS risk index is accurate and replicable in predicting MCI, and is applicable in community interventions for dementia prevention.
轻度认知障碍（MCI）是预防干预的关键痴呆前目标。基于自我报告的个人生活方式和与健康相关的信息，很少有简短的筛选工具可以预测 MCI，这些工具在初级保健和社区环境中的通用性和实用性尚未得到验证。
开发和验证 MCI 风险预测指数，并在试点社区干预试验项目中评估其现场应用。
新加坡纵向老龄化研究（SLAS）中的两个独立的基于人群的队列。我们使用 SLAS1 作为开发队列来构建风险评估工具，使用 SLA2 作为验证队列来验证其通用性。
基于社区的筛查和生活方式干预
（1）年龄≥55 岁、认知正常（CN）的 SLAS1（N=1601）；（2）SLAS2 队列（N=3051），随访平均 4 年。（3）在试点社区干预项目中，有 437 名参与者。
风险指数指标包括年龄、女性、受教育年限、听力损失、抑郁、生活满意度、心血管代谢危险因素（宽腰围、糖尿病前期或糖尿病、高血压、血脂异常）数量。加权总分预测 MCI 或痴呆的概率。风险指数的自我管理问卷现场版本在试点社区项目中使用，并根据参与者的干预前认知功能进行评估。
风险评分与发展队列中向 MCI 或痴呆进展的概率增加相关（AUC=0.73），与验证队列中 MCI 或痴呆的患病率和发病率增加相关（AUC=0.74）。社区计划中，现场问卷风险指数识别出高风险个体，与 RBANS 认知评分具有很强的相关性（p<0.001）。
SLAS 风险指数在预测 MCI 方面准确且可复制，适用于社区痴呆预防干预。
