Pankratz et al developed risk scores for development of mild cognitive impairment (MCI) in older adults. One set of scores is for males and another for females. The authors are from the Mayo Clinic with the study performed in Olmsted County, Minnesota.
Patient selection: adult female from 70 to 89 years of age
Outcome: mild cognitive impairment
Parameters for the augmented models:
(1) education in years
(2) self-reported memory concerns
(3) ever diagnosed with alcohol problem
(4) history of stroke
(5) diabetes AND age at assessment
(6) history of atrial fibrillation
(7) presence of agitation on Neuropsychiatric Inventory (NPI)
(8) presence of apathy on NPI
(9) presence of anxiety on NPI
(10) Clinical Dementia Rating (CDR) sum of boxes
(11) APOE epsilon 4 carrier
(12) Short Test of Mental Status (STMS)
(13) midlife dyslipidemia
(14) Unified Parkinson's Disease Rating Scale (UPDRS) total score
(15) Functional Activities Questionnaire (FAQ) total score
|
Parameter |
Finding |
Points without APOE Results |
Points with APOE Results |
|
education in years |
<= 12 years |
2 |
2 |
|
|
> 12 years |
0 |
0 |
|
self-reported memory concern |
no |
0 |
0 |
|
|
yes |
4 |
5 |
|
alcohol problem |
no |
0 |
0 |
|
|
yes |
2 |
3 |
|
history of stroke |
no |
0 |
0 |
|
|
yes |
2 |
2 |
|
diabetes and age |
no diabetes |
0 |
0 |
|
|
diabetes and < 75 years |
14 |
19 |
|
|
diabetes and 75 to 84 |
6 |
9 |
|
|
diabetes and 85 to 89 |
0 |
0 |
|
history of atrial fibrillation |
no |
0 |
0 |
|
|
yes |
2 |
2 |
|
agitation on NPI |
no |
0 |
0 |
|
|
yes |
14 |
20 |
|
apathy on NPI |
no |
0 |
0 |
|
|
yes |
5 |
7 |
|
anxiety on NPI |
no |
0 |
0 |
|
|
yes |
6 |
6 |
|
CDR sum of boxes |
0 |
0 |
0 |
|
|
>0 |
19 |
26 |
|
APOE epsilon 4 carrier |
no |
NA |
0 |
|
|
yes |
NA |
8 |
|
STMS |
>= 37 |
0 |
0 |
|
|
35-36 |
23 |
32 |
|
|
33-34 |
34 |
46 |
|
|
<33 |
38 |
51 |
|
midlife dyslipidemia |
no |
0 |
0 |
|
|
yes |
6 |
8 |
|
UPDRS |
0 |
0 |
0 |
|
|
> 0 |
1 |
1 |
|
FAQ |
0 |
0 |
0 |
|
|
> 0 |
1 |
2 |
total score =
= SUM(points for all 15 parameters)
Interpretation:
• minimum score: 0
• maximum score without APOE: 116
• maximum score with APOE: 162
|
Score without APOE |
Quartile |
Median MCI-free Survival |
|
< 27 |
1 |
> 95 years |
|
27 to 36 |
2 |
89.5 years |
|
37 to 45 |
3 |
87.1 years |
|
>= 46 |
4 |
81.8 years |
|
Score with APOE |
Quartile |
Median MCI-free Survival |
|
< 38 |
1 |
92.3 years |
|
38 to 49 |
2 |
89.5 years |
|
50 to 62 |
3 |
86.6 years |
|
>= 63 |
4 |
81.8 years |
Performance:
• The area under the ROC curve is 0.69.
Specialty: Neurology
