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Development of a novel dementia risk prediction model in the general population: A large, longitudinal, population-based machine-learning study.

作者信息

You Jia, Zhang Ya-Ru, Wang Hui-Fu, Yang Ming, Feng Jian-Feng, Yu Jin-Tai, Cheng Wei

机构信息

Department of Neurology, Huashan Hospital, Institute of Science and Technology for Brain-Inspired Intelligence, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China.

Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, China.

出版信息

EClinicalMedicine. 2022 Sep 23;53:101665. doi: 10.1016/j.eclinm.2022.101665. eCollection 2022 Nov.


DOI:10.1016/j.eclinm.2022.101665
PMID:36187723
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9519470/
Abstract

BACKGROUND: The existing dementia risk models are limited to known risk factors and traditional statistical methods. We aimed to employ machine learning (ML) to develop a novel dementia prediction model by leveraging a rich-phenotypic variable space of 366 features covering multiple domains of health-related data. METHODS: In this longitudinal population-based cohort of the UK Biobank (UKB), 425,159 non-demented participants were enrolled from 22 recruitment centres across the UK between March 1, 2006 and October 31, 2010. We implemented a data-driven strategy to identify predictors from 366 candidate variables covering a comprehensive range of genetic and environmental factors and developed the ML model to predict incident dementia and Alzheimer's Disease (AD) within five, ten, and much longer years (median 11.9 [Interquartile range 11.2-12.5] years). FINDINGS: During a follow-up of 5,023,337 person-years, 5287 and 2416 participants developed dementia and AD, respectively. A novel UKB dementia risk prediction (UKB-DRP) model comprising ten predictors including age, , pairs matching time, leg fat percentage, number of medications taken, reaction time, peak expiratory flow, mother's age at death, long-standing illness, and mean corpuscular volume was established. Our prediction model was internally evaluated based on five-fold cross-validation on discrimination and calibration, and it was further compared with existing prediction scales. The UKB-DRP model can achieve high discriminative accuracy in dementia (AUC 0.848 ± 0.007) and even better in AD (AUC 0.862 ± 0.015). The model was well-calibrated (Hosmer-Lemeshow goodness-of-fit -value = 0.92), and the predictive power was solid in different incidence time groups. More importantly, our model presented an apparent superiority over existing models like Cardiovascular Risk Factors, Aging, and Incidence of Dementia Risk Score (AUC 0.705 ± 0.008), the Dementia Risk Score (AUC 0.752 ± 0.007), and the Australian National University Alzheimer's Disease Risk Index (AUC 0.584 ± 0.017). The model was internally validated in the general population of European ancestry and White ethnicity; thus, further validation with independent datasets is necessary to confirm these findings. INTERPRETATION: Our ML-based UKB-DRP model incorporated ten easily accessible predictors with solid predictive power for incident dementia and AD within five, ten, and much longer years, which can be used to identify individuals at high risk of dementia and AD in the general population. FUNDING: This study was funded by grants from the Science and Technology Innovation 2030 Major Projects (2022ZD0211600), National Key R&D Program of China (2018YFC1312904, 2019YFA070950), National Natural Science Foundation of China (282071201, 81971032, 82071997), Shanghai Municipal Science and Technology Major Project (2018SHZDZX01), Research Start-up Fund of Huashan Hospital (2022QD002), Excellence 2025 Talent Cultivation Program at Fudan University (3030277001), Shanghai Rising-Star Program (21QA1408700), Medical Engineering Fund of Fudan University (yg2021-013), and the 111 Project (No. B18015).

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4826/9519470/400a5179ced1/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4826/9519470/3bfec633ce1c/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4826/9519470/855ffcafbcff/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4826/9519470/d20e731f2289/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4826/9519470/400a5179ced1/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4826/9519470/3bfec633ce1c/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4826/9519470/855ffcafbcff/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4826/9519470/d20e731f2289/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4826/9519470/400a5179ced1/gr4.jpg

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Integrative machine learning approach to risk prediction for dementia and Alzheimer's disease.

Geroscience. 2025-8-27

[2]
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BMC Med. 2025-7-31

[3]
Medical laboratory data-based models: opportunities, obstacles, and solutions.

J Transl Med. 2025-7-24

[4]
The CAIDE dementia risk score indicates elevated cognitive risk in late adulthood: a structural and functional neuroimaging study.

Geroscience. 2025-6-26

[5]
Development and multi-center validation of a high-performance predictive model for early detection of cognitive impairment in older adults: data-based on communities in Northern China.

Neurol Sci. 2025-6-14

[6]
Development and validation of a novel predictive model for dementia risk in middle-aged and elderly depression individuals: a large and longitudinal machine learning cohort study.

Alzheimers Res Ther. 2025-5-13

[7]
Investigating causal networks of dementia using causal discovery and natural language processing models.

NPJ Dement. 2025

[8]
Association of Body Mass Index in Late Life, and Change from Midlife to Late Life, With Incident Dementia in the ARIC Study Participants.

Neurology. 2025-5-13

[9]
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[10]
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Aging Clin Exp Res. 2025-3-8

本文引用的文献

[1]
Poor pulmonary function is associated with mild cognitive impairment, its progression to dementia, and brain pathologies: A community-based cohort study.

Alzheimers Dement. 2022-12

[2]
A Research Ethics Framework for the Clinical Translation of Healthcare Machine Learning.

Am J Bioeth. 2022-5

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Trials. 2021-8-16

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Int J Geriatr Psychiatry. 2020-9

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A prediction model for one- and three-year mortality in dementia: results from a nationwide hospital-based cohort of 50,993 patients in the Netherlands.

Age Ageing. 2020-4-27

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Chest. 2020-6

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BMC Pulm Med. 2019-11-7

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Alzheimers Dement. 2019-10-13

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Association between regional body fat and cardiovascular disease risk among postmenopausal women with normal body mass index.

Eur Heart J. 2019-9-7

[10]
Big data and machine learning algorithms for health-care delivery.

Lancet Oncol. 2019-5

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