Chai Yiyi, Ye Qingfang, Wu Xiaomin, Gu Yanrong, Zhang Zheng, Zhu Dou, Wang Yini, Lin Ping, Li Ling
Harbin Medical University, Harbin, China.
Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 315000, China.
Aging Clin Exp Res. 2025 Jul 23;37(1):229. doi: 10.1007/s40520-025-03132-2.
Coronary artery disease (CAD) is well known to be associated with dementia, motoric cognitive risk syndrome (MCR) has been identified as a predictor of dementia, with MCR and CAD potentially sharing common pathophysiological mechanisms. Identifying MCR in CAD patients is beneficial for the prevention of dementia. This study aims to investigate the incidence and identify the risk factors of MCR in CAD patients, and further establish a visual risk prediction model.
A cross-sectional study. From September 2023 to December 2023, we enrolled 413 CAD patients for this study. Patients were randomly grouped into a training cohort (80%) and a validation cohort (20%). The least absolute shrinkage and selection operator regression model and multivariate logistic regression analysis were used to select variables and develop a prediction model in the training cohort. In both the training and validation cohorts: ROC curve was used to evaluate the differentiation of the nomogram model; the calibration curve was used to evaluate the consistency of the model; the decision curve analysis was used to evaluate the efficiency of the nomogram.
In this study, the prevalence of MCR was 13.8%. Four risk predictors, namely polypharmacy, handgrip strength, Gensini score, and neutrophil counts, were screened and used to develop a nomogram model. The ROC curve of the training set was 0.781 (95%CI: 0.71, 0.86). Similar ROC curve was achieved at validation set 0.780 (95%CI: 0.62, 0.94). The Hosmer-Lemeshow test in the training, and testing cohorts were p = 0.993, and p = 0.782, calibration curve analysis demonstrated that the model was well-calibrated. DCA exhibited this model with clinical utility.
We developed a nomogram that could help clinicians identify high-risk groups of MCR in middle-aged and elderly CAD patients for early intervention.
冠状动脉疾病(CAD)与痴呆症密切相关,运动认知风险综合征(MCR)已被确定为痴呆症的预测指标,MCR和CAD可能具有共同的病理生理机制。在CAD患者中识别MCR有助于预防痴呆症。本研究旨在调查CAD患者中MCR的发生率,确定其危险因素,并进一步建立可视化风险预测模型。
一项横断面研究。2023年9月至2023年12月,我们招募了413例CAD患者进行本研究。患者被随机分为训练队列(80%)和验证队列(20%)。使用最小绝对收缩和选择算子回归模型及多因素逻辑回归分析在训练队列中选择变量并建立预测模型。在训练队列和验证队列中:采用ROC曲线评估列线图模型的区分度;采用校准曲线评估模型的一致性;采用决策曲线分析评估列线图的有效性。
在本研究中,MCR的患病率为13.8%。筛选出四个风险预测因素,即多重用药、握力、Gensini评分和中性粒细胞计数,并用于建立列线图模型。训练集的ROC曲线为0.781(95%CI:0.71,0.86)。验证集的ROC曲线为0.780(95%CI:0.62,0.94)。训练队列和测试队列的Hosmer-Lemeshow检验p值分别为0.993和0.782,校准曲线分析表明模型校准良好。决策曲线分析显示该模型具有临床实用性。
我们开发了一种列线图,可帮助临床医生识别中老年CAD患者中MCR的高危人群,以便进行早期干预。