Abstract
BackgroundOur study aimed to determine whether the consideration of socio-demographic features improves the prediction of Alzheimer’s dementia (AD) at 5 years when using the Free and Cued Selective Reminding Test (FCSRT) in the general older population.MethodsOur analyses focused on 2558 subjects from the prospective Three-City Study, a cohort of community-dwelling individuals aged 65 years and over, with FCSRT scores. Four “residual scores” and “risk scores” were built that included the FCSRT scores and socio-demographic variables. The predictive performance of crude, residual and risk scores was analyzed by comparing the areas under the ROC curve (AUC).ResultsIn total, 1750 subjects were seen 5 years after completing the FCSRT. AD was diagnosed in 116 of them. Compared with the crude free-recall score, the predictive performances of the residual score and of the risk score were not significantly improved (AUC: 0.83 vs 0.82 and 0.88 vs 0.89 respectively).ConclusionUsing socio-demographic features in addition to the FCSRT does not improve its predictive performance for dementia or AD.
Highlights
Our study aimed to determine whether the consideration of socio-demographic features improves the prediction of Alzheimer’s dementia (AD) at 5 years when using the Free and Cued Selective Reminding Test (FCSRT) in the general older population
The coefficients of the linear regressions used to produce the expected FCSRT scores according to age, agesquared, sex and level of education are shown in Additional file 1: Table S1
Comparisons of the areas under the receiver operating curve (ROC) curve (AUC) for the ROC curves of the crude and residual scores (Table 2 and Fig. 2a, b) showed that, compared with the crude scores, the residual scores did not improve the prediction of dementia or AD occurrence at 3 or 5 years, and between 3 and 5 years, whichever FCSRT score was considered
Summary
Our study aimed to determine whether the consideration of socio-demographic features improves the prediction of Alzheimer’s dementia (AD) at 5 years when using the Free and Cued Selective Reminding Test (FCSRT) in the general older population. Because the AD pathophysiological process begins several years or decades before the clinical diagnosis [1,2,3], it seems more promising, for treating the disease, to act upstream of the clinical stage, before the installation of irreversible damage [4] The development of such therapies requires the early identification of patients with AD at the predementia stage. Sociodemographic features (sex, age and education) strongly influence cognitive scores [11,12,13,14,15,16] and the dementia risk [17] Combining these characteristics with the results of an episodic memory test could improve dementia prediction. Such a “residual score” was recently proposed by Reed et al [19] for quantifying the cognitive reserve [20] from the scores of an episodic memory test after removing the variability due to socio-demographic factors and level of brain pathology
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