RISK SCORE FOR PREDICTION OF DEMENTIA RISK IN 10 YEARS AMONG OLDER ADULTS: A NORDIC POPULATION-BASED STUDY WITH THREE COHORTS

Abstract

The midlife CAIDE Dementia Risk Score for estimating the risk of dementia development 20 years later in middle-aged people (45–59 years) is one of the few validated risk scores that has also been used to select participants in the successful FINGER lifestyle intervention trial. The present study aims to develop and validate a late-life risk score for estimating dementia risk in older populations (60+ years). Data analysis were based on three population-based studies: the Swedish National study on Aging and Care in Kungsholmen (SNAC-K; n=2281; age ≥60 years), the Kungsholmen project in Sweden (n=987; age 75–95 years), and the Cardiovascular Risk Factors, Aging and Dementia study in Finland (CAIDE; n=744; age 65–79 years). Data on demographics, lifestyle, psychosocial factors, vascular factors, and health status were collected following similar procedures. The three Nordic studies were used to develop the late-life dementia risk score, which will be validated in the Rotterdam Study in the Netherlands (>60 years). Cox regression was used in the data analyses with a 10-year horizon. Incidence of dementia during the follow-up period (up to 10 years) was 12.7%. The predictors for dementia varied between younger-old (60–74 years) and older-old (≥75 years) individuals. In the younger-old group, future dementia was significantly predicted by higher age (70–74 years), low diastolic blood pressure (<70 mmHg), physical inactivity, cerebrovascular disease, and the number of heart diseases. In the older-old group, future dementia was significantly predicted by higher age (≥80 years), low education (<7 years), diabetes mellitus, physical inactivity, cerebrovascular diseases, self-reported depression, and subjective memory complaints. The Harrell's C statistic was 0.74 for the dementia risk score in the younger-old group, and 0.70 for the dementia risk score in the older-old group. External validation in the Rotterdam study is ongoing. This approach highlights the role of cardiovascular diseases and mental health in the development of dementia in old and very old adults, which could further benefit dementia prevention and clinical interventions. Dementia risk estimation tools are much needed for identification of at-risk individuals who may benefit most from preventive interventions.