CAIDE Dementia Risk Score Research Articles

Exploring the Relationship Between CAIDE Dementia Risk and EEG Signal Activity in a Healthy Population

Background: Accounting for dementia risk factors is essential in identifying people who would benefit most from intervention programs. The CAIDE dementia risk score is commonly applied, but its link to brain function remains unclear. This study aims to determine whether the variation in this score is associated with neurophysiological changes and cognitive measures in normative individuals. Methods: The sample comprised 38 participants aged between 54 and 79 (M = 67.05; SD = 6.02). Data were collected using paper-and-pencil tests and electroencephalogram (EEG) recordings in the resting state, channels FP1 and FP2. The EEG signals were analyzed using Power Spectral Density (PSD)-based features. Results: The CAIDE score is positively correlated with the relative power activation of the θ band and negatively correlated with the MMSE cognitive test score, and MMSE variations align with those found in distributions of EEG-extracted PSD-based features. Conclusions: The findings suggest that CAIDE scores can identify individuals without noticeable cognitive changes who already exhibit brain activity similar to that seen in people with dementia. They also contribute to the convergent validity between CAIDE and the risk of cognitive decline. This underscores the importance of early monitoring of these factors to reduce the incidence of dementia.

Prevention of dementia using mobile phone applications (PRODEMOS): a multinational randomised controlled effectiveness-implementation trial

Abstract Background The expected increase of dementia prevalence in the coming decades will mainly be within low-and middle-income countries and those with low socioeconomic status (SES) in high income countries. Forty percent of dementia is associated with modifiable, lifestyle-related cardiovascular risk factors. Mobile health interventions with remote coaching can help reach underserved high-risk populations globally. Methods This open label, blinded endpoint, hybrid effectiveness-implementation randomised controlled trial (RCT) investigated whether a coach-supported mHealth intervention can reduce dementia risk in persons aged 55-75 years of low SES in UK or from the general population in China with at least two dementia risk factors. The primary effectiveness outcome was change in CAIDE dementia risk score (including age, education, sex, systolic blood pressure, total cholesterol, BMI, physical exercise) after 12-18 months of intervention. Main implementation outcomes were coverage, acceptability, appropriateness, adoption, feasibility, sustainability, fidelity, and costs using a mixed methods approach. Findings Between 15th January 2021 and 18th April 2023, 1,488 persons were included and randomised (734 intervention, 754 control), with 1,229 (82·6%) available for analysis of the primary effectiveness outcome. After a mean follow-up of 16 months, the mean CAIDE score improved by 0·16 points in the intervention group vs. 0·01 in the control group (Mean Difference (MD) 0·16, 95% Confidence Interval (CI) 0·03-0·29). The effect was larger in those who adhered to the intervention (MD 0·27, 95%CI 0·12-0·44) and those planning to change lifestyle (MD 0·33, 95%CI 0·10-0·57). Ten percent of those invited participated; of these, 81% adopted the intervention and 50% continued active participation throughout the study. For the individual components of the CAIDE score, there were no statistically significant differences for systolic blood pressure, total cholesterol and BMI, but in the intervention group physical inactivity was reduced more than in the control group (MD 6·7%, 95%CI 2·1 to 11·2) and more participants quit smoking (MD -3·1%, 95%CI -4·8 to -1·5). Interpretation A coach-supported mHealth intervention to improve lifestyle is modestly effective in reducing dementia risk factors in those with low SES in the UK and any SES in China. Implementation is challenging in these populations, but those reached actively participated. Whether this will result in less cognitive decline and dementia requires a larger RCT with long follow-up.

Mediating Factors Associated With Physical Activity in Older Adults at Increased Dementia Risk.

While regular physical-activity (PA) is beneficial, multimorbid individuals at increased dementia risk may exhibit reduced PA levels. Thus, a more comprehensive understanding of mediating factors responsible for inactivity in this population is needed. This study investigated the impact of a multimodal intervention on PA changes at 24-month follow-up and associated mediating factors among community-dwelling patients aged 60-77, with increased dementia risk determined by the CAIDE Dementia Risk Score. Of 1030 participants recruited, 819 completed the assessment. Thus, a generalized estimating equations model initially assessed differences in PA over 24 months, followed by a tree analysis identifying mediating factors influencing PA changes post-intervention. While no significant effect on regular PA was found during the follow-up (P = .674), subgroup analysis revealed improved self-efficacy (P = .000) associated with increased engagement in PA. Incorporating self-efficacy elements into future strategies is crucial for promoting PA among individuals with multimorbidity and at increased dementia risk.

How to perform a general population‐based recruitment strategy for a multidomain intervention trial for dementia prevention—the CITA GO‐ON trial experience

AbstractBackgroundFINGER trial has demonstrated the potential for dementia prevention by targeting different lifestyle domains in older adults. It highlighted the importance of selecting the correct window of opportunity for preventive actions by including participants at high risk of dementia. This approach is being tested worldwide to support future public health interventions, where the selection of the appropriate target population is crucial. Here we share our approach and results in recruiting older adults with increased dementia risk and cognitive frailty from the general population for the CITA Go‐On trial.MethodCITA GO‐ON is a single‐center randomized controlled trial in which non‐demented‐adults between 60‐80y will be allocated to receive standard care or a risk factor control and lifestyle‐based multidomain intervention. It replicates FINGER trial inclusion criteria, but the recruitment strategy is based on the community level in Gipuzkoa (Spain) instead of a previous health registry. Together with press and social media releases, mailing, and small group talks, the main recruitment strategy has been coordinated with local governments. Interested people fulfill an online form that allows identifying those who meet the pre‐established requirements (CAIDE dementia risk score ≥6) prior to attending an individualized face‐to‐face cognitive screening visit (evaluation of exclusion criteria and brief cognitive testing).ResultBy December 2022, we have reached and informed about the trial more 24000 people including all citizens older than 60 in three small municipalities in collaboration with the local town halls. Of these, 1919 completed the pre‐screening questionnaire using REDCap, 868 were screened and 450 recruited (mean age: 68,57 (6,58), 50,87% female, and mean CAIDE: 7,49 (1,39)). In person calculated (mean (sd): 6,98 (1,70)) and self‐reported (mean (sd): 7,23 (1,77)) CAIDE score is similar (p = 0,062) in our experience. Table 1 resumes age, sex, CAIDE and MMSE of the interested sample. Recruitment period is still opened.ConclusionCITA GO‐ON recruitment is a multi‐disciplinary population oriented efficient strategy to identify adults at high risk of dementia understanding and willing to participate in a multi‐modal intervention prevention trial. It allows to select candidates from the whole population, and not only those linked to specialized health care systems or registries.

Physical function characteristics among older adults at high risk of developing cognitive decline

AbstractBackgroundPhysical function profiles of older adults (≥ 60years) cognitively unimpaired but at high risk of dementia (CAIDE dementia risk score ≥6) have not been well described. The CAIDE index evaluates both modifiable, cardiovascular (CVRF), and non‐modifiable risk factors such as age, sex and educational level. The association of these factors with physical function has not been thoroughly studied.MethodWe present preliminary cross‐sectional data from the first 2 (out of 4) recruitment waves of the CITA Go‐On study, a FINGER‐like multimodal intervention prevention trial. Inclusion criteria were based on age (≥60 and ≤85) and CAIDE score (≥6). Participants were categorized according to their cognitive status. Physical function assessment included gait speed, handgrip strength and maximum leg strength measured as 1 repetition maximum (1RM). We explored physical function by CAIDE scale, regarding hypertension (i.e. systolic >140mmHg or diastolic >90mmHg), hypercholesterolemia (i.e >250 mg/dL) and body mass index (BMI) as modifiable risk factors, and accounting for age, sex and educational level as non‐modifiable ones. Analysis was performed with SPSS v.29.ResultSample of 380 subjects aged 68.4 ± 5.6 years (mean, SD), 50% women, Mini‐Mental State Examination (MMSE) mean of 28.4 ±1.7 and CAIDE index mean was 7.4 ± 1.3. Of these, 91.6% were cognitively preserved, 5.5% had subjective complaints and 2.9% mild cognitive impairment. Dyslipidemia was present in 23.4%, hypertension in 46.9% and 63.1% showed BMI of overweight or obese. Univariate regression analysis showed that CAIDE index was significantly associated to maximum leg strength (1RM) (η2 = 0.05, p = 0.008), after adjusting for non‐modifiable risk factors (age η2 = 0.054, p = 0.001; sex η2 = 0.453, p = 0.001; and educational level η2 = 0.003, p = 0.333) and BMI (η2 = 0.156, p = 0.001). Handgrip strength and gait speed were not explained by modifiable factors in our sample (p = 0.12 and p = 0.53).ConclusionPhysical function as measured by maximum leg strength is associated with CAIDE dementia risk index, and most significantly with sex and BMI component, with age displaying a moderate effect. Together with vascular risk factor control, interventions on physical function are important for prevention.

Baseline characteristics and study progress of the CITA GO‐ON Study. A FINGER‐like Multidomain Intervention to Prevent Cognitive Decline in Spain

AbstractBackgroundThe FINGER study demonstrated the efficacy of a non‐pharmacological multidomain intervention to prevent cognitive decline in at‐risk older adults. After a successful pilot feasibility study, in Q3 2021 we launched the CITA GO‐ON study, inspired by FINGER methodology to demonstrate the efficacy of a risk factor and lifestyles multimodal intervention to prevent cognitive decline in southern Europe. Here we describe the baseline characteristics of participants recruited in the study.MethodThe CITA GO‐ON study (ClinicalTrials.gov, NCT04840030) is a two‐year randomized, controlled trial. The primary aim is to reduce the risk of decline in cognitive functioning in the Neuropsychology Test Battery after two years by a multi‐modal intervention on risk factors and protective life‐styles as compared to standard health care. Inclusion criteria are: 60‐85 years old; CAIDE dementia risk score ≥ 6; cognitive frailty; no dementia. The multidomain intervention includes optimized control of cardiovascular risk factors; correction of polypharmacy; cognitive training; physical exercise program; socioemotional intervention; and promotion of adherence to the Mediterranean diet.ResultsTo date, 1964 individuals completed pre‐screening using self‐administered online survey in REDCap (Research Electronic Capture) and 874 (44.5%) fulfilled criteria for an in‐person screening visit. Screening was successful in 477 of participants. Mean (SD) age is 66.24 (4.99), 13.26 (4.43) years of education, MMSE 28.27 (1.78), CAIDE score 7.48 (1.36), and 235 (49%) are men. Based on CAIDE components, at baseline, 287 (60%) showed high systolic blood pressure, 165 (35%) low physical activity, 122 (26%) high BMI, and 101 (21%) with high cholesterol. Regarding cognitive frailty, 144 (31%) presented low performance on brief cognitive testing (Memory Alteration Test ≤ 40 and/or Fototest ≤ 35), 186 (39%) presented memory complaints (Cognitive Change Index ≥ 20), and 147 (30%) showed both criteria. Currently, 191 have been randomly assigned to the control and 192 to the Intervention groups. So far, adherence to intervention activities is high, ranging from 73% to 97%, depending on the modality.ConclusionCITA GO‐ON Study recruitment strategy includes participants with high risk of dementia based on modifiable factors and in situation of cognitive fragility, with might increase the probability of obtaining positive efficacy results.

Associations of Depressive Symptoms with Subjective Cognitive Decline in Elderly People-A Cross-Sectional Analysis from the AgeWell.de-Study.

To develop effective dementia prevention strategies, it is necessary to understand risk factors, associated factors and early signs of dementia. Subjective cognitive decline (SCD) is the earliest form of dementia. The aim of this study is to assess depression as a factor that is significantly associated with SCD. The data of 1030 general practitioner patients from the AgeWell.de-study (60-77 years; CAIDE dementia risk score ≥ 9) were analysed. A descriptive analysis was conducted using validated instruments like the Geriatric depression scale (GDS), Lubben social network scale (LSNS-6) and education classes according to CASMIN (Comparative Analysis of Social Mobility in Industrial Nations). A multivariate regression model with the dependent variable SCD was calculated. Of the 1030 participants, 5.9% had depressive symptoms and 31.3% SCD. The group with depressive symptoms showed significantly higher body-mass-index (p = 0.005), lower education class (p = 0.022), lower LSNS-6 score (p < 0.001), higher sports activity (p < 0.001), and more sleeping problems (p = 0.026). In the regression model a higher GDS-score [Odds ratio (OR): 1.219 (p < 0.001)], more sleeping problems [OR: 1.550 (p = 0.017)] and higher education class [middle/high: OR: 1.474/1.875 (p = 0.037/0.004)] were significantly associated with SCD. This study identified depressive symptoms, sleeping problems, and higher education classes as factors associated with SCD, which can represent an early form of dementia.

Macrostructural brain alterations at midlife are connected to cardiovascular and not inherited risk of future dementia: the PREVENT-Dementia study

BackgroundMacrostructural brain alterations in the form of brain atrophy or cortical thinning typically occur during the prodromal Alzheimer’s disease stage. Mixed findings largely dependent on the age of the examined cohorts have been reported during the preclinical, asymptomatic disease stage. In the present study, our aim was to examine the association of midlife dementia risk with brain macrostructural alterations.MethodsStructural 3T MRI scans were acquired for 647 cognitively normal middle-aged (40–59 years old) participants in the PREVENT-Dementia study. Cortical thickness, volumes of subcortical structures, the hippocampus and hippocampal subfields were quantified using Freesurfer version 7.1. The clarity of the hippocampal molecular layer was evaluated based on T2-weighted hippocampal scans. Associations of structural measures with apolipoprotein ε4 (APOE4) genotype and dementia family history (FHD), were investigated using linear regression. Correlations between the CAIDE dementia risk score (incorporating information about blood pressure, cholesterol, physical activity, body mass index, education, age and sex) and structural measures were further investigated.ResultsA higher CAIDE score was associated with thinner cortex and a larger hippocampal fissure. APOE4 genotype was associated with reduced molecular layer clarity.ConclusionsOur findings suggest that a higher CAIDE score is associated with widespread cortical thinning. Conversely, APOE4 carriers and participants with FHD do not demonstrate prominent macrostructural alterations at this age range. These findings indicate that cardiovascular and not inherited risk factors for dementia are associated with macrostructural brain alterations at midlife.

Cardiovascular and dementia risk scores and their association with dementia‐related biomarkers in a memory clinic population

AbstractBackgroundRisk scores for dementia and cardiovascular disease (CVD) predict dementia development, but their link to underlying brain pathology remains unclear. This study explored the cross‐sectional associations between well‐validated CVD and dementia risk scores and dementia‐related cerebrospinal fluid (CSF) and imaging markers in memory clinic patients without dementia,MethodThe study population consisted of 207 patients with subjective cognitive impairment or mild cognitive impairment from the Karolinska University Hospital, Theme Aging, Memory Clinic, who had CSF (Aβ42, phosphorylated tau, total tau, neurofilament light chain NfL), visual MRI ratings (medial temporal lobe atrophy MTA, Fazekas for white matter lesions WML), and available clinical data to calculate risk scores. CVD risk score (FINRISK) was calculated for all patients; data for the CAIDE Dementia Risk Score (with and without APOE) were available for a subsample (N=88). The associations between risk scores and biomarkers were analyzed with linear regression (zero‐skewness log‐transformed CSF biomarkers as dependent variables) and ordinal regression (MTA and WML ratings as dependent variables). Risk scores were categorized into 3 similar‐sized groups (lower‐, intermediate‐, and higher‐risk groups; lower‐risk group used as reference),ResultHigher FINRISK score and CAIDE score (with APOE) were associated with lower levels of CSF Aβ42 (coefficients in the higher‐risk groups ‐0.05, p=0.02 for FINRISK and ‐0.08, p=0.04 for CAIDE). Higher CAIDE score (with APOE) was also associated with a lower CSF Aβ42/p‐tau ratio (coefficient ‐0.03, p=0.03 in the higher‐risk group). With respect to neuronal injury markers, a higher risk of CVD and dementia was associated with higher CSF NfL levels (coefficients in the higher‐risk groups 0.58, p&lt;0.001 for FINRISK; 0.38, p=0.001 for CAIDE; 0.34, p=0.005 for CAIDE with APOE). Furthermore, higher‐risk patients had more pronounced MTA (OR 2.3, 95% CI 1.2–4.5 for FINRISK; OR 3.0, 95% CI 1.2–7.4 for CAIDE), and WML (OR 2.4, 95% CI 1.2–4.5 for FINRISK),ConclusionHaving a higher risk of CVD or dementia was associated with several dementia‐related CSF and imaging markers. Follow‐up studies are needed to explore the utility of different risk scores in assessing risk of cognitive decline and disease progression in memory clinic patients.

Change in CAIDE dementia risk score and neuroimaging biomarkers during a 2‐year multidomain lifestyle randomized controlled trial

AbstractBackgroundThe Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) risk score was the first validated risk score estimating dementia risk based on a midlife risk profile. This exploratory study investigated associations of change in CAIDE score with change in neuroimaging biomarkers: brain magnetic resonance imaging (MRI) and Pittsburgh compound B‐positron emission tomography (PiB‐PET) measures during the 2‐year Finnish Geriatric Intervention Study to prevent cognitive impairment and disability (FINGER).MethodFINGER targeted an at‐risk 60‐77 years old general population without dementia/substantial cognitive impairment. Data from baseline and 2‐year visits were used. 112 participants (59 intervention, 53 control) had repeated brain MRI measures (hippocampal, total gray matter, and white matter lesion volumes, and Alzheimer’s disease (AD) signature cortical thickness). Repeated PiB‐PET scans were available for 39 participants (18 intervention, 21 control). Linear regressions were used to test the association of CAIDE score change with change in MRI and PiB‐PET measures.ResultReduction in CAIDE score was associated less decline in hippocampus volume in the intervention group, but not the control group (randomization group x CAIDE change interaction β‐coefficient= ‐0.40; p=0.02). Associations for other MRI measures and amyloid accumulation on PiB‐PET scans were not significant.ConclusionReduction in estimated dementia risk as indicated by the CAIDE score change may result in more pronounced intervention benefits on hippocampus volume. Findings from this study should be verified in clinical trials with larger neuroimaging sample sizes and longer follow‐up.

Secular changes in dementia risk indices among 70-year-olds: a comparison of two Finnish cohorts born 20\xa0years apart

AimsTo compare dementia risk indices among two separate cohorts of 70-year-olds born 20 year apart.MethodsCommunity-dwelling 70-year-old Finns were examined with similar examinations in 1991 (n = 1032) and in 2011 (n = 960). Dementia risk was assessed with the CAIDE Dementia Risk Score (CAIDE) (n = 1516), the Brief Dementia Risk Index (BDRI) (n = 1598) and the Dementia Screening Indicator (DSI) (n = 1462).ResultsThe proportion of subjects with moderate or high risk for dementia was significantly higher in earlier than in later born cohort according to CAIDE (99% and 94%, respectively, p < 0.001) and BDRI (41% and 15%, p < 0.001), but not according to DSI (5% and 6%, p = 0.184). The total scores of the earlier born cohort were significantly higher than those of the later born cohort according to all three indices.ConclusionsAccording to dementia risk indices, it seems that dementia risk has decreased among community-dwelling 70-year-old subjects during the last decades in Finland.

Allocentric and Egocentric Spatial Processing in Middle-Aged Adults at High Risk of Late-Onset Alzheimer's Disease: The PREVENT Dementia Study.

Impairments in spatial processing due to hippocampal degeneration have been observed in the years immediately preceding the diagnosis of Alzheimer's disease (AD) dementia. The demonstration of changes in spatial processing in preceding decades would provide a cognitive marker for pre-clinical AD and an outcome measure for early intervention trials. The present study examined allocentric and egocentric spatial processing in relation to future dementia risk in a middle-aged cohort. The CAIDE Dementia Risk Score (DRS) was calculated for 188 persons aged 40 to 59, of whom 94 had a parent with dementia. Participants underwent the Four Mountains Test (4MT) of allocentric spatial processing, the Virtual Reality Supermarket Trolley Task (VRSTT) of egocentric spatial processing, and 3T MRI scans. A significant negative association was found between the DRS and 4MT (Spearman correlation - 0.26, p = 0.0006), but not with the VRSTT. The 4MT was also found to be a better predictor of risk than tests of episodic memory, verbal fluency, or executive functioning. The results suggest that allocentric rather than egocentric processing may be a potential indicator of risk for late-onset AD, consistent with the hypothesis that the earliest cognitive changes in AD are driven by tau-related degeneration in the medial temporal lobe rather than amyloid-only deposition in the medial parietal lobe.

CAIDE Dementia Risk Score, Alzheimer and cerebrovascular pathology: a population-based autopsy study.

CAIDE Dementia Risk Score is a tool for estimating dementia risk in the general population. Its longitudinal associations with Alzheimer or vascular neuropathology in the oldest old are not known. To explore the relationship between CAIDE Dementia Risk Score at baseline and neuritic plaques, neurofibrillary tangles, cerebral infarcts and cerebral amyloid angiopathy (CAA) after up to 10-year follow-up in the Vantaa 85+ population. Study population included 149 participants aged ≥85years, without dementia at baseline, and with available clinical and autopsy data. Methenamine silver staining was used for β-amyloid and modified Bielschowsky method for neurofibrillary tangles and neuritic plaques. Macroscopic infarcts were identified from cerebral hemispheres, brainstem and cerebellum slices. Standardized methods were used to determine microscopic infarcts, CAA and α-synuclein pathologies. The CAIDE Dementia Risk Score was calculated based on scores for age, sex, BMI, total cholesterol, systolic blood pressure, physical activity and APOEε4 carrier status (range 0-18 points). A CAIDE Dementia Risk Score above 11 points was associated with more cerebral infarctions up to 10years later: OR (95% CI) was 2.10 (1.06-4.16). No associations were found with other neuropathologies. In a population of elderly aged ≥85years, higher CAIDE Dementia Risk Score was associated with increased risk of cerebral infarcts.

B-24Predicting Progression from Mild Cognitive Impairment to Dementia with CAIDE Dementia Risk Score

B-24Predicting Progression from Mild Cognitive Impairment to Dementia with CAIDE Dementia Risk Score

Cardiorespiratory Fitness And Brain Structures - The Finger Study

Executive processes and frontal cortical regions supporting them show notable changes with age. Structural magnetic resonance imaging studies have revealed a positive relationship between cardiorespiratory fitness (CRF) and brain volume in several cortical regions and in the medial temporal lobe. However, previous studies have been mainly focused on cognitively intact subjects. Furthermore, no sex differences have been reported. PURPOSE: To investigate whether CRF is associated with total gray matter (GM) and white matter volumes as well as medial temporal lobe and striatum volumes in a population-based sample of subjects with increased risk of Alzheimer’s disease. We also examined the role of sex in the association of CRF with brain volumes. METHODS: We used baseline data from the FINGER study. Participants had elevated CAIDE Dementia Risk Score. Inclusion criteria was set to select persons with cognitive performance at the mean level or slightly lower than expected for age according to Finnish population norms. Our substudy included 68 randomly selected individuals (39 men and 29 women) with 61-75 years of age. Cardiorespiratory fitness was assessed as peak oxygen consumption (VO2peak, ml/kg/min) measured directly in a symptom-limited maximal exercise test on cycle ergometer. Structural imaging was performed using a 1.5-Tesla scanner. Volumetric segmentation was performed with the Freesurfer automated image analysis suite. All brain volumes were expressed as ratios after normalizing by the total intracranial volume. RESULTS: In whole group, VO2peak was associated with left caudate volume (β=0.32, p=0.03), cortical GM volume (β=0.37, p=0.01) and total GM volume (β=0.40, p=0.007). In men, VO2peak was associated with cortical GM volume (β=0.61, p=0.001) and total GM volume (β=0.59, p=0.001). In women, VO2peak was associated with the left caudate volume (β=0.49, p=0.04). Peak oxygen consumption accounted for 23 and 1 percent of total variance of cortical GM volume in men and women, respectively. Likewise, VO2peak accounted for 25 and 4 percent of total variance of total GM volume in men and women, respectively. CONCLUSION: Cardiorespiratory fitness is associated with cortical and total gray matter volumes in elderly men with increased risk for Alzheimer’s disease.

Midlife CAIDE Dementia Risk Score and Dementia-Related Brain Changes up to 30 Years Later on Magnetic Resonance Imaging

CAIDE Dementia Risk Score is a validated tool for estimating 20-year dementia risk in the general population based on a midlife risk profile. To investigate the associations between CAIDE score and dementia-related brain changes up to 30 years later on magnetic resonance imaging (MRI). Participants in the Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study were derived from random, population-based samples surveyed in 1972, 1977, 1982, or 1987. A first re-examination was conducted in 1998, and a second re-examination in 2005-2008 (total follow-up time up to 30 years). The MRI study population included 112 individuals with MRIs from the first re-examination, and a different group of 69 individuals with MRIs from the second re-examination. MRIs from 1998 were used to determine gray matter volume, and to visually rate white matter hyperintensities (WMH) of presumed vascular origin and medial temporal lobe atrophy (MTA). MRIs from 2005-2008 were used to assess cortical thickness, gray matter and WMH volume, and to visually rate MTA. CAIDE scores were calculated for participants in both re-examinations based on midlife sociodemographic and vascular factors and additionally apolipoprotein E status. Higher midlife CAIDE score was associated with more severe WMH 20 years later: RR (95% CI) was 1.69 (1.15-2.08); and with higher WMH volume (β 0.27, p = 0.036) and higher MTA score (RR 1.91, 95% CI 1.16-2.34) up to 30 years later. CAIDE Dementia Risk Score in midlife was most consistently associated with WMH later in life. A relation with MTA was observed in individuals with longer follow-up time.

The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER): Study design and progress

BackgroundFinnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) is a multi-center, randomized, controlled trial ongoing in Finland. MaterialsParticipants (1200 individuals at risk of cognitive decline) are recruited from previous population-based non-intervention studies. Inclusion criteria are CAIDE Dementia Risk Score ≥6 and cognitive performance at the mean level or slightly lower than expected for age (but not substantial impairment) assessed with the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropsychological battery. The 2-year multidomain intervention consists of: nutritional guidance; exercise; cognitive training and social activity; and management of metabolic and vascular risk factors. Persons in the control group receive regular health advice. The primary outcome is cognitive performance as measured by the modified Neuropsychological Test Battery, Stroop test, and Trail Making Test. Main secondary outcomes are: dementia (after extended follow-up); disability; depressive symptoms; vascular risk factors and outcomes; quality of life; utilization of health resources; and neuroimaging measures. ResultsScreening began in September 2009 and was completed in December 2011. All 1200 persons are enrolled and the intervention is ongoing as planned. Baseline clinical characteristics indicate that several vascular risk factors and unhealthy lifestyle–related factors are present, creating a window of opportunity for prevention. The intervention will be completed during 2014. ConclusionsThe FINGER is at the forefront of international collaborative efforts to solve the clinical and public health problems of early identification of individuals at increased risk of late-life cognitive impairment, and of developing intervention strategies to prevent or delay the onset of cognitive impairment and dementia.

O1-02-07: The CAIDE dementia risk score: A practical tool to predict dementia risk in 20 years among middle aged persons

O1-02-07: The CAIDE dementia risk score: A practical tool to predict dementia risk in 20 years among middle aged persons

CAIDE Dementia Risk Score Validated in Study

CAIDE Dementia Risk Score Validated in Study