A new scoring tool hopes to help doctors accurately predict their patient’s risk of developing dementia over time, according to a recent study published in JAMA Network Open.
The researchers developed a point-based risk score prediction model for dementia that’s meant to help clinicians and patients intervene and take action early to delay or prevent future cognitive problems.
“A practical risk score tool was developed for individual prediction of dementia risk, which may help individuals identify their potential risk profile and provide guidance on precise and timely actions to promote dementia delay or prevention,” Xi-Jian Dai, PhD, corresponding author of The Second Affiliated Hospital of Nanchang University in China, told Seasons.
The researchers used data from nearly 450,000 men and women, with an average age of 56, who were also considered cognitively normal at baseline to develop a practical tool to predict individual dementia risk.
They also looked at other key variables to help predict dementia risk, including age, education level, sleep patterns and health issues like diabetes, hypertension, cardiovascular and cerebrovascular complications, and respiratory disease.
Based on these risk factors, participants were given a score which would then be applied to a specific formula that determines their future chance of developing dementia at 5, 9 and 13 years.
According to the researchers, the risk score tool was 97.59% accurate in predicting dementia risk at nine years for men and 99.59% accurate in predicting dementia risk in women. In addition, the tool was 100% accurate in predicting dementia risk at 13 years for both men and women.
“The risk score model yielded nearly 100% prediction possibility of 13-year dementia risk both in men and women,” Dai said. “By this tool, we can search the high-risk population of dementia.”
The risk score model yielded nearly 100% prediction possibility of 13-year dementia risk both in men and women.
Limitations of the study and risk score tool
The researchers noted there are some limitations to their study, and the results have not been validated or replicated by other research groups. Further, because the study only analyzed data from individuals who were part of the UK Biobank, the tool may not apply to those in other populations.
James Richardson, MD, MPH, geriatrician and palliative medicine physician who was not involved in the study, told Seasons there are additional limitations to consider, including how patients self-reported certain data and were hospitalized within a strict age range.
“I’m not sure how applicable this study is to other populations. Other concerns I had were that, as the researchers noted, some data was self-reported by subjects,” Richardson said. “Also, all the study participants were hospitalized—certainly not representative of the whole population.”
Other experts believe the claim of 100% accuracy seems unrealistic, especially because the researchers only looked at specific risk factors and did not include alternative factors that could impact dementia risk.
“That raises eyebrows. That means that no other factors than what they’ve identified contributed to dementia, and we know that’s not true,” Karen Sullivan, PhD, ABPP, a board-certified neuropsychologist and expert in Alzheimer’s, dementia and brain health, told Seasons. “For example, they didn’t account for diet.
Sullivan said the score does not accurately predict if someone will develop dementia in 13 years, but rather it provides the probability that somebody will develop dementia.
“The researchers claim that the risk score model provided a 100% accurate prediction of who gets dementia in 13 years, but that’s a misrepresentation,” she added.
Other experts have weighed in as well with their own hesitations about the study’s results:
“As the authors’ note, ‘dementia’ covers several diseases: Alzheimer’s disease, vascular dementia, frontal temporal dementia among others,” wrote Prof. John Hardy, chair of molecular biology of neurological disease at the UCL Institute of Neurology. “Given this mix of diseases, it is surprising that there should be a ‘one size fits all’ prediction algorithm. If this algorithm replicates in a separate cohort, then it will be a significant step forward.”
Can this tool be useful, and how can I use it?
Despite some of the study’s limitations, Sullivan said the tool can help the public understand the cumulative impact of risk factors, like age, socioeconomic adversity, sleep symptoms, respiratory disease and other diseases on dementia risk.
The tool can help the public understand the cumulative impact of risk factors… on dementia risk.
“The goal of this tool is to motivate people to take action to reduce these risk factors; many of them are modifiable and, if managed, can delay or prevent cognitive symptoms,” she said. “I could see this tool being helpful in folks seeing the big picture for the health of their brain. Sometimes that’s what it takes for people to take action.”
According to Dai, the research team is currently working to make their tool easily available to other populations; however, those who have access to statistical software programs can use the formula provided in the study to calculate their risk score for dementia.
Those who want to learn more about their risk of dementia should contact their health care provider about available screening options and cognitive assessments, along with other ways to manage or control modifiable risk factors to reduce the risk of dementia.
“I counsel children of patients with dementia to control modifiable risk factors, including blood pressure, blood sugar (if diabetic), maintain good sleep hygiene, stop smoking, stay active physically and avoid excessive alcohol intake,” Richardson said.