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Cognitive and physical markers of prodromal dementia: A 12‐year‐long population study
Author(s) -
Grande Giulia,
Rizzuto Debora,
Vetrano Davide L.,
Marseglia Anna,
Vanacore Nicola,
Laukka Erika J.,
Welmer AnnaKarin,
Fratiglioni Laura
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.12002
Subject(s) - dementia , confidence interval , hazard ratio , neuropsychology , medicine , cognition , population , proportional hazards model , cognitive impairment , gerontology , psychiatry , disease , environmental health
The aim is to test whether adding a simple physical test such as walking speed (WS) to the neuropsychological assessment increases the predictive ability to detect dementia. Methods The 2546 dementia‐free people from the SNAC‐K study were grouped into four profiles: (1) healthy profile; (2) isolated cognitive impairment, no dementia (CIND, scoring 1.5 standard deviation below age‐specific means on ≥1 cognitive domains); (3) isolated slow WS (<0.8 m/s); (4) CIND+ slow WS. The hazard of dementia (Cox regression), the positive and negative predictive values (PPV, NPV), and the area under the curve (AUC) were estimated. Results Participants with CIND +slow WS demonstrated the highest hazard of dementia (3.4; 95% confidence interval [CI]: 2.5–4.8). The AUC increased from 0.69 for isolated CIND to 0.83 for CIND+ slow WS. Such an increase was due to the improvement of the PPV, the NPV remaining optimal. Discussion Adding WS to the cognitive assessment dramatically increases the diagnostic accuracy of prodromal dementia.