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S4‐03–05: Insulin resistance/metabolic syndrome and cognitive impairment
Author(s) -
Yaffe Kristine
Publication year - 2008
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 - 10.1016/j.jalz.2008.05.490
Subject(s) - dementia , metabolic syndrome , insulin resistance , disease , obesity , cognitive aging , medicine , cognition , cognitive impairment , cognitive decline , population , diabetes mellitus , gerontology , bioinformatics , psychology , psychiatry , endocrinology , biology , environmental health
approach is to focus on risk factors profiles already at midlife. The latter approach would give possibilities for primary prevention. Risk scores have been developed to predict cardiovascular events, diabetes and mortality, and could be helpful also in identifying individuals at an increased dementia risk. Methods: This is a brief review of prognostic models for cognitive impairment and dementia with a special focus on the Caide Dementia Risk Score and its practical implications. Results: We sought to develop a simple method for predicting the risk of subsequent dementia in middleaged people based on their risk profiles. Several midlife vascular and lifestyle related risk factors were considered. Score values were estimated based on beta-coefficients. The Dementia Risk Score was the sum of individual scores (range 0-15). High age, low education, midlife hypertension, hypercholesterolemia, obesity, and physical inactivity significantly predicted dementia (AUC 0.77; 95% CI 0.71-0.83). Dementia probability increased as the risk score increased. The Caide Dementia Risk Score has been recently validated in the multiethnic population from the Kaiser Permanente Study with similar predictive values. A risk score based on late-life risk profiles is currently being developed using data from the extended follow-up of the Caide study. Conclusions: The Dementia Risk Score is a novel approach for predicting dementia risk. It provides a quantitative estimation of the probability of becoming demented, but it cannot definitely state whether a person will develop dementia. Thus, it should not be used to label individuals, but is more an educational tool and may help to identify individuals who can benefit from intensive lifestyle consultations and pharmacological interventions. A multi-domain intervention study based on the Dementia Risk Score is currently being planned.