Dementia is a major global health challenge, with a significant impact on patients, families, and healthcare systems. Accurate risk assessment tools are crucial for early detection and prevention.
However, a new study published in JAMA Network Open on June 13 has raised questions about the effectiveness of current dementia risk scores.
Researchers led by Dr. Mika Kivimäki from University College London evaluated the accuracy of four commonly used dementia risk scores.
They analyzed data from 465,929 participants in the UK Biobank study, who were dementia-free at the start, and validated the findings with 4,865 participants in the Whitehall II study.
High Error Rates
The study found high error rates in all four risk scores.
When calibrated to achieve a 5% false-positive rate, these scores detected only 9% to 16% of new dementia cases and missed 84% to 91%. A model that included age as the only factor had a similar failure rate of 84%.
When adjusted to detect at least half of future dementia cases, the ratio of true positives to false positives was poor across the board.
For example, the CAIDE APOE-supplemented score had a ratio of 1 to 66, while the Australian National University Alzheimer Disease Risk Index (ANU-ADRI) had a ratio of 1 to 116. Age alone as a predictor had a ratio of 1 to 43.
Limited Clinical Utility
The C statistic, a measure of a model’s discrimination ability, was underwhelming for all scores, ranging from 0.59 for ANU-ADRI to 0.79 for age alone.
The researchers concluded that these scores have limited value for identifying individuals who would benefit from preventive interventions.
Given the high incidence and burden of dementia, the study underscores the urgent need for more reliable and accurate risk assessment tools.
Healthcare professionals and policy makers will need to consider these findings when implementing preventive measures for dementia.
“The scores were of limited value in targeting people for dementia prevention,” the authors noted, highlighting the immediate need for more effective ways to assess dementia risk.
If you care about brain health, please read studies about how the Mediterranean diet could protect your brain health, and these antioxidants could help reduce dementia risk.
For more information about brain health, please see recent studies about Vitamin B9 deficiency linked to higher dementia risk, and results showing flavonoid-rich foods could improve survival in Parkinson’s disease.
The study was published in JAMA Network Open.
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