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
Specialty: Neurology