大脑健康平台：结合韧性、脆弱性和表现来评估大脑健康以及阿尔茨海默病和相关疾病的风险。
The Brain Health Platform: Combining Resilience, Vulnerability, and Performance to Assess Brain Health and Risk of Alzheimer's Disease and Related Disorders.
机构信息
Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, Boca Raton, FL, USA.
Department of Mathematical Sciences, Florida Atlantic University, Boca Raton, FL, USA.
出版信息
J Alzheimers Dis. 2022;90(4):1817-1830. doi: 10.3233/JAD-220927.
BACKGROUND
It is difficult to assess brain health status and risk of cognitive impairment, particularly at the initial evaluation. To address this, we developed the Brain Health Platform to quantify brain health and identify Alzheimer's disease and related disorders (ADRD) risk factors by combining a measure of brain health: the Resilience Index (RI), a measure of risk of ADRD; the Vulnerability Index (VI); and the Number-Symbol Coding Task (NSCT), a measure of brain performance.
OBJECTIVE
The Brain Health Platform is intended to be easily and quickly administered, providing an overview of a patient's risk of developing future impairment based on modifiable and non-modifiable factors as well as current cognitive performance.
METHODS
This cross-sectional study comprehensively evaluated 230 participants (71 controls, 71 mild cognitive impairment, 88 ADRD). VI and RI scores were derived from physical assessments, lifestyle questionnaires, demographics, medical history, and neuropsychological examination including the NSCT.
RESULTS
Individuals with abnormal scores were 95.7% likely to be impaired, with a misclassification rate of 9.7%. The combined model had excellent discrimination (AUC:0.923±0.053; p < 0.001), performing better than the Montreal Cognitive Assessment.
CONCLUSION
The Brain Health Platform combines measures of resilience, vulnerability, and performance to provide a cross-sectional snapshot of overall brain health. The Brain Health Platform can effectively and accurately identify even the very mildest impairments due to ADRD, leveraging brief yet powerful and actionable indices of brain health and risk that could be used to develop personalized, precision medicine-like interventions.
背景
评估大脑健康状况和认知障碍风险，尤其是在初始评估时，具有一定难度。为解决这一问题，我们开发了大脑健康平台，通过整合大脑健康测量指标、阿尔茨海默病和相关疾病（ADRD）风险测量指标，来量化大脑健康并识别 ADRD 风险因素。该测量指标包括：大脑健康测量指标-韧性指数（RI）、ADRD 风险测量指标-脆弱性指数（VI）、大脑性能测量指标-数字符号编码测试（NSCT）。
目的
大脑健康平台旨在便于快速管理，基于可改变和不可改变因素以及当前认知表现，为患者提供未来发生损害的风险概况。
方法
本横断面研究全面评估了 230 名参与者（71 名对照者、71 名轻度认知障碍者、88 名 ADRD 患者）。VI 和 RI 评分来自体格检查、生活方式问卷、人口统计学、病史和神经心理学检查，包括 NSCT。
结果
异常分数的个体有 95.7%的可能受损，错误分类率为 9.7%。综合模型具有出色的辨别力（AUC：0.923±0.053；p<0.001），优于蒙特利尔认知评估。
结论
大脑健康平台整合了韧性、脆弱性和表现测量指标，提供了大脑健康的整体横断面图像。大脑健康平台可以有效地、准确地识别出 ADRD 导致的最轻微的损害，它利用了简短而强大且可操作的大脑健康和风险指标，可以用于制定个性化、精准医学干预措施。
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