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P3‐107: Standard laboratory tests to identify older adults at increased risk of cognitive decline
Author(s) -
Searle Samuel,
Howlett Susan,
Rockwood Kenneth
Publication year - 2015
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.2015.06.975
Subject(s) - dementia , medicine , univariate , logistic regression , univariate analysis , cognitive decline , multivariate analysis , cohort , prospective cohort study , gerontology , multivariate statistics , mini–mental state examination , cohort study , frailty index , cognition , physical therapy , psychiatry , statistics , disease , mathematics
Background:A growing body of work investigates liquid biomarkers for dementia and cognitive impairment. Abnormalities in common laboratory tests have been combined (in a frailty index based on laboratory measures the FI-Lab) to predict many adverse health outcomes, including death, independently of a clinical frailty index. We investigated whether the FI-lab was associated with cognitive decline.Methods:This is a secondary analysis of the Canadian Study of Health and Aging, a prospective cohort study of community-dwelling and institutionalized Canadians aged 65 years and older. The FIlab was created from tests done for the first clinical examination. The FI-Lab was correlated with the Mini-Mental State Examination (MMSE) at baseline. Univariate and multivariate logistic regression were conducted for a 2+ point decline in MMSE or an incident dementia diagnosis at the five year follow-up. Results:Of 1013 patients who had complete FI-lab data, 467were alive at follow up, 355 (76%) had baseline and follow upMMSE and 391 had a follow up diagnosis. Patients with missing follow-up data had a lower baseline MMSE (18.6 average) and were more likely to be institutionalized at follow up (71%). A worse FI-lab was associated with a worse baseline MMSE (p<0.001). In univariate analysis, the FI-lab was associated with a clinically significant decline of MMSE at follow up (p1⁄40.033). In multivariate analysis FI-lab and sex were not significantly associated with MMSE decline but a clinical frailty index (p<0.001), age (p<0.001) and education (p1⁄40.031) were significantly associated. The FI-lab was, in multivariate analysis, associated with a future diagnosis of dementia (p1⁄40.019). Conclusions:An incident dementia diagnosis was associated with a frailty index based on common laboratory tests. These data support the notion that dementia in old age is associated with widespread, even subclinical, health deficits, likely reflecting widespread problems of repair. How these relate to biomarkers is a question of some interest, to be pursued.