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Calculator validated for home-based dementia risk screening

Journal
Journal of Epidemiology and Community Health
Reuters Health - 08/07/2021 - An online calculator may be an effective way for community-dwelling adults to screen for dementia risk at home, a new study suggests.

Researchers examined data collected from 75,460 participants in the Canadian Community Health Survey between 2001 and 2012 to identify potential self-reported risk factors for dementia, then tested the validity of these risk factors based on five-year incidence of physician-diagnosed dementia derived from individual linkage to administrative healthcare records.

Over 348,677 person-years of follow-up, there were 8,448 cases of incident dementia. The five-year cumulative incidence was higher among women (0.057) than men (0.044).

The Dementia Population Risk Tool (DemPoRT) developed based on the survey results included 65 main effects and 25 interactions as well as 28 predictors of dementia risk, including 8 continuous predictors. The algorithm developed for the calculator was discriminating in both women and men (C-statistic in validation data 0.83 for both sexes), researchers report in the Journal of Epidemiology and Community Health.

"Other complex algorithms for dementia risk prediction are designed for use in the clinical setting, and often require neuropsychological testing, brain imaging and the collection of other clinical variables," said lead study author Stacey Fisher of the University of Toronto and Public Health Ontario.

"This tool is unique in that individuals can use it to predict their dementia risk from the comfort of their own home," Fisher said by email. "The goal is to empower people with information about their brain health and what they can do to reduce their risk of developing dementia."

Unlike clinical risk screening tools, the online calculator evaluated in the study relies only on self-reported risk factors. It accounts for a wide range of socio-demographic factors such as education and marital status; health behaviors such as smoking, drinking, eating, and exercise habits; functional measures such as personal hygiene, mobility, and ability to manage finances and daily tasks; and common physical and mental health conditions.

A dementia risk calculator is available to consumers online (https://www.projectbiglife.ca/dementia), and the study team has posted supplemental materials on the github website (https://bit.ly/2Ux5t7B).

One limitation of the study is that the algorithm was developed using only physician-diagnosed dementia, and it's possible that some individuals may have undiagnosed dementia, the authors note.

"No prediction is 100%, but it can give people and their health care team a better idea of how much risk they have of dementia," said Dr. Glen Finney, director of the Memory and Cognition Program at Geisinger Health and a professor of neurology at the Geisinger Commonwealth School of Medicine in Scranton, Pennsylvania.

However, the calculator should supplement rather than replace conversations about dementia risk between clinicians and patients, Dr. Finney, who wasn't involved in the study, said by email.

"This calculator will allow patients to perform a test at home and bring the results to their primary physicians," said Dr. Thomas Holland of the Institute for Health Aging at Rush University Medical Center in Chicago.

"This not only empowers individuals to take charge of the brain health, in the event they have a less than desired outcome, but also offer some aspect of reassurance," Dr. Holland, who wasn't involved in the study, said by email.

SOURCE: https://bit.ly/3yx2quC Journal of Epidemiology and Community Health, online June 25, 2021.

By Lisa Rapaport



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