Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.
J Alzheimers Dis. 2021;84(4):1729-1746. doi: 10.3233/JAD-215077.
There is increasing interest in lifestyle modification and integrative medicine approaches to treat and/or prevent mild cognitive impairment (MCI) and Alzheimer's disease and related dementias (ADRD).
To address the need for a quantifiable measure of brain health, we created the Resilience Index (RI).
This cross-sectional study analyzed 241 participants undergoing a comprehensive evaluation including the Clinical Dementia Rating and neuropsychological testing. Six lifestyle factors including physical activity, cognitive activity, social engagements, dietary patterns, mindfulness, and cognitive reserve were combined to derive the RI (possible range of scores: 1-378). Psychometric properties were determined.
The participants (39 controls, 75 MCI, 127 ADRD) had a mean age of 74.6±9.5 years and a mean education of 15.8±2.6 years. The mean RI score was 138.2±35.6. The RI provided estimates of resilience across participant characteristics, cognitive staging, and ADRD etiologies. The RI showed moderate-to-strong correlations with clinical and cognitive measures and very good discrimination (AUC: 0.836; 95% CI: 0.774-0.897) between individuals with and without cognitive impairment (diagnostic odds ratio = 8.9). Individuals with high RI scores (> 143) had better cognitive, functional, and behavioral ratings than individuals with low RI scores. Within group analyses supported that controls, MCI, and mild ADRD cases with high RI had better cognitive, functional, and global outcomes than those with low RI.
The RI is a brief, easy to administer, score and interpret assessment of brain health that incorporates six modifiable protective factors. Results from the RI could provide clinicians and researchers with a guide to develop personalized prevention plans to support brain health.
人们越来越关注生活方式的改变和整体医学方法，以治疗和/或预防轻度认知障碍（MCI）和阿尔茨海默病及相关痴呆症（ADRD）。
为了满足对大脑健康量化评估方法的需求，我们创建了复原力指数（RI）。
这项横断面研究分析了 241 名参与者，他们接受了全面评估，包括临床痴呆评分和神经心理学测试。将 6 种生活方式因素（包括身体活动、认知活动、社交活动、饮食模式、正念和认知储备）结合起来，得出 RI（得分范围：1-378）。确定心理测量学特性。
参与者（39 名对照组、75 名 MCI、127 名 ADRD）的平均年龄为 74.6±9.5 岁，平均受教育年限为 15.8±2.6 年。平均 RI 评分为 138.2±35.6。RI 提供了对参与者特征、认知分期和 ADRD 病因的复原力的估计。RI 与临床和认知测量值具有中度至强相关性，且在认知正常与认知障碍个体之间具有很好的区分度（AUC：0.836；95%CI：0.774-0.897；诊断比值比=8.9）。RI 得分较高（>143）的个体比 RI 得分较低的个体具有更好的认知、功能和行为评分。组内分析支持 RI 得分较高（>143）的对照组、MCI 和轻度 ADRD 病例的认知、功能和总体结局优于 RI 得分较低的病例。
RI 是一种简短、易于管理、评分和解释的大脑健康评估方法，包含 6 种可改变的保护因素。RI 的结果可为临床医生和研究人员提供制定个性化预防计划以支持大脑健康的指南。
