O1–02–07: The CAIDE dementia risk score: A practical tool to predict dementia risk in 20 years among middle aged persons

Several vascular risk factors have been related to dementia and AD. Risk scores are already available for predicting cardiovascular events, and could be helpful also in identifying individuals at an increased risk for dementia. We sought to develop a simple method for the prediction of the risk of late-life dementia in people of middle age on the basis of their risk profiles. The population-based Cardiovascular Risk Factors Aging and Dementia (CAIDE) study includes 1409 participants who were studied in midlife (mean age 50 years) and re-examined 20 years later to detect dementia. Several midlife vascular risk factors were studied: systolic and diastolic blood pressure, serum total cholesterol, BMI, and smoking. The significant risk factors were entered simultaneously into a model. The score values were estimated based on the beta-coefficients, and the Dementia Risk Score was composed as the sum of the individual scores (range 0–15). The occurrence of dementia during the 20 years of follow-up was 4.3%. Statistically significant independent predictors of future dementia were high age, low education, hypertension, hypercholesterolemia, and obesity. The Dementia Risk Score predicted dementia well (AUC 0.77; 95% CI 0.71–0.83). The risk of dementia according to the categories of Dementia Risk Score was 1.0% for a score of 0–5; 1.9% for a score of 6–7; 4.2% for a score of 8–9; 7.3% for a score of 10–11; and 16.4% for a score of 12–15. When the cut-off ≥9 points was applied, the sensitivity was 0.77, the specificity was 0.63, and the negative predictive value was 0.98. The Dementia Risk Score is a novel approach for developing a practical tool to predict dementia risk. We are currently further developing the risk score by adding new variables and testing their validity in the Kaiser Permanente population in the US. The Dementia Risk Score highlights the role of vascular factors in the development of dementia, and may help to identify individuals who can benefit from intensive lifestyle consultations and pharmacological interventions.