No difference in dementia prediction between apolipoprotein E4 and the ischemic score
Shahram Oveisgharan1, Vladimir Hachinski2
1Rush Azlheimer's Disease Center, Rush University of Medical Sciences, Chicago, Illinois, USA.
Insights
The Hachinski Ischemic Scale (HIS) effectively predicts dementia risk in older adults. This simple tool shows similar predictive power to apolipoprotein E (APOE ɛ4) for identifying individuals at risk of cognitive decline.
Area of Science:
- Neurology
- Geriatrics
- Biomarker Research
Background:
- Vascular cognitive impairment lacks sufficient early detection biomarkers.
- Identifying reliable predictors for dementia is crucial for timely intervention.
Purpose of the Study:
- To evaluate the Hachinski Ischemic Scale (HIS) as a predictor of dementia in the elderly.
- To compare the predictive performance of HIS against apolipoprotein E (APOE ɛ4).
Main Methods:
- Utilized data from the Canadian Study of Health and Aging.
- Examined the association between HIS scores and incident dementia.
- Developed and validated predictive models for dementia using HIS and APOE ɛ4 in training and validation datasets.
Main Results:
- Higher HIS scores significantly correlated with increased odds of dementia (OR = 1.64).
- The dementia prediction accuracy of the HIS model was comparable to the APOE ɛ4 model (AUC difference = 0.002).
- Both HIS and APOE ɛ4 models demonstrated acceptable calibration.
Conclusions:
- The Hachinski Ischemic Scale serves as a valuable, accessible tool for identifying elderly individuals at risk of dementia.
- HIS offers a practical alternative for dementia risk assessment in clinical settings.
Introduction:
Few biomarkers exist for early detection of vascular cognitive impairment. We examined whether the Hachinski Ischemic Scale (HIS) can predict dementia in elderly.
Methods:
We leveraged data of the Canadian Study of Health and Aging. First, we examined the association of HIS with incident dementia. Next, we compared HIS to apolipoprotein E (APOE ɛ4) in prediction of dementia. We trained the HIS and APOE ɛ4 models in the training dataset and used the trained models for dementia prediction in the validation dataset.
Results:
A higher HIS level was associated with a higher odds of dementia (odds ratio = 1.64, 95% confidence interval [CI]: 1.41 to 1.90, P < .001). Dementia discrimination of the HIS model was not different from the APOE ɛ4 model (area under the curve difference = 0.002, 95% CI: -0.024 to 0.029, P = .857). The calibration of the HIS model was 13.7 (P = .091) and of the APOE ɛ4 model was 13.3 (P = .100).
Discussion:
HIS may be used as a simple, inexpensive test to identify older adults at risk of developing dementia.
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