Enhancing dementia prediction: A 19-year validation of the CAIDE risk score with insulin resistance and APOE ε4 integration in a population-based cohort - 01/01/25

Doi : 10.1016/j.tjpad.2024.100034

Elina Pietilä ^a,^b,^⁎ , Eliisa Löyttyniemi ^c, Seppo Koskinen ^d, Jenni Lehtisalo ^d, Matti Viitanen ^e,^f, Juha O. Rinne ^a,^b,^g, Antti Jula ^h, Laura L. Ekblad ^a,^b,^e
^a Turku PET Centre, University of Turku, Turku, Finland
^b Turku PET Centre, Turku University Hospital, Turku, Finland
^c Department of Biostatistics, University of Turku and Turku University Hospital, Finland
^d Finnish Institute for Health and Welfare, Helsinki, Finland
^e Department of Geriatrics, Turku University Hospital, Wellbeing services county of Southwestern Finland, Finland
^f Division of Clinical Geriatrics, NVS, Karolinska Institutet, Stockholm, Sweden
^g InFLAMES Research Flagship Center, University of Turku, Turku, Finland
^h Finnish Institute for Health and Welfare, Turku, Finland

^∗Corresponding author.

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Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Wednesday 01 January 2025

Highlights

•	CAIDE dementia risk score predicts dementia well in a population-based cohort.
•	Insulin resistance (HOMA-IR) is comparable to obesity as part of CAIDE risk score.
•	CAIDE risk score is applicable for assessing risk of dementia.

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Abstract

Background

Dementia is a significant cause of disability and dependency. Persons with high dementia risk but intact cognition will benefit from preventive interventions.

Objectives

The aim was to validate dementia risk score Cardiovascular Risk Factors, Aging and Incidence of Dementia (CAIDE) in a national population-based cohort with data on age, education, hypertension, obesity, hyperlipidemia and physical activity. Secondly, we examined if substituting obesity item with Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) would improve predictive value of CAIDE risk score.

Design

Longitudinal, population-based cohort study.

Setting

General population, Finland

Participants

Representative sample of Finnish adult population aged over 30 years from Health 2000 Survey (n = 5,806).

Measurements

CAIDE dementia risk score and substituting BMI with HOMA-IR.

Results

Dementia was diagnosed in 571 (9.8 %) participants during the 19 years follow-up. CAIDE risk score predicted dementia well: AUC (area under curve) ROC (receiver-operating characteristic) was 0.78 (95 % CI from 0.76 to 0.79). Secondly, replacing obesity with HOMA-IR in CAIDE risk score generated similar results: ROC AUC 0.78 (95 % CI from 0.76 to 0.80). Adding APOE ε4 status further improved predictive value of risk score: ROC AUC 0.81 (95 % CI from 0.80 to 0.83).

Conclusions

CAIDE dementia risk score predicts dementia well in a national population-based cohort. Adding APOE ε4 genotype improved predictive value of risk score. Insulin resistance measured by HOMA-IR is comparable to obesity as part of CAIDE risk score. These findings imply that CAIDE risk score is applicable for assessing risk of dementia and highlight importance of modifiable risk factors of dementia.

Le texte complet de cet article est disponible en PDF.