Description

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 male 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) maximum adult BMI in kg per square meter

(13) marital status

(14) gait speed

(15) anxiety on Beck Anxiety Inventory (BAI)

(16) depression on Beck Depression Inventory (BDI)

(17) Short Test of Mental Status (STMS)

 

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

maximum BMI

< 30

0

0

 

>= 30

4

5

marital status

married or divorced

0

0

 

never married or widowed

9

13

gait speed

>= 0.9 m/s

0

0

 

< 0.9 (slow)

9

11

anxiety on BAI

<8

0

0

 

>=8

6

9

depression on BDI

<13

0

0

 

>=13

3

5

STMS

>= 37

0

0

 

35 or 36

14

19

 

33 or 34

21

27

 

< 33

29

39

 

total score =

= SUM(points for all 17 parameters)

 

Interpretation:

• minimum score: 0

• maximum score without APOE: 130

• maximum score with APOE: 182

 

Score without APOE

Quartile

Median MCI-free Survival

< 19

1

92 years

19 to 27

2

89.5 years

28 to 37

3

80.5 years

>= 38

4

77.5 years

 

 

Score with APOE

Quartile

Median MCI-free Survival

< 27

1

93 years

27 to 38

2

89.5 years

39 to 53

3

78.2 years

>= 54

4

76.4 years

 

Performance:

• The area under the ROC curve is 0.71


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