Department of Sport, Physical Education and Health, The Hong Kong Baptist University, Academic and Administrative Building, AAB931, Kowloon Tong, Hong Kong SAR, China.
Department of Psychiatry, The Chinese University of Hong Kong, Sha Tin, Hong Kong SAR, China.
BMC Geriatr. 2024 Mar 21;24(1):277. doi: 10.1186/s12877-024-04879-5.
Early cognitive deficits commonly seen in older people have not been well defined and managed in primary care. The objectives are (1) to develop and validate a new risk score to estimate the risk of dementia in Chinese older population; and (2) to evaluate the use of risk score in conjunction with cognitive screening in detecting early cognitive deficits in community older people.
A development cohort of 306 cognitive healthy older adults aged 60 or above were followed for 6 years. A CARS was constructed using the estimated coefficients of risk factors associated with dementia at follow up. Validation was carried out in another five-year cohort of 383 older adults. The usefulness of CARS in detecting early cognitive deficits was evaluated.
Risk factors include older age, male gender, low level of education, poorly controlled diabetes, prolonged sleep latency, fewer mind body or light exercise, loneliness, and being apolipoprotein e4 carriers. A cutoff of CARS at -1.3 had a sensitivity of 83.9% and a specificity of 75.4% to predict dementia. The area under curve was 82.5% in the development cohort. Early cognitive deficits were characterized by impaired retention (p <.001, 95% CI 0.2-0.9) and attention (p =.012, 95% CI 0.1-0.8).
The CARS can be used as a standard risk assessment of dementia or in conjunction with a computerized cognitive screening to evaluate a full cognitive profile for detecting early cognitive deficits. The result put forward the integration of risk algorithm into smart healthcare system to provide personalized lifestyle interventions.
老年人中常见的早期认知缺陷在初级保健中尚未得到很好的定义和管理。目的是（1）开发和验证一种新的风险评分，以估计中国老年人群痴呆的风险；（2）评估风险评分与认知筛查结合在检测社区老年人早期认知缺陷中的应用。
对 306 名年龄在 60 岁及以上认知健康的老年人进行了 6 年的随访。使用与随访时痴呆相关的危险因素的估计系数构建了 CARS。在另外 383 名老年人的 5 年队列中进行了验证。评估了 CARS 在检测早期认知缺陷中的作用。
危险因素包括年龄较大、男性、受教育程度较低、糖尿病控制不佳、睡眠潜伏期延长、较少的身心或轻度运动、孤独感和载脂蛋白 E4 携带者。CARS 的截断值为-1.3 时，预测痴呆的敏感性为 83.9%，特异性为 75.4%。在发展队列中，曲线下面积为 82.5%。早期认知缺陷的特征是记忆力下降（p<.001，95%CI 0.2-0.9）和注意力下降（p=.012，95%CI 0.1-0.8）。
CARS 可用于痴呆的标准风险评估，或与计算机认知筛查相结合，评估全面认知特征以检测早期认知缺陷。该结果提出了将风险算法集成到智能医疗保健系统中，为患者提供个性化的生活方式干预措施。
