A pragmatic dementia risk score for patients with mild cognitive impairment in a memory clinic population: Development and validation of a dementia risk score using routinely collected data

Area of Science:

• Neurology
• Geriatrics
• Cognitive Science

Background:

• Mild cognitive impairment (MCI) is a transitional stage between normal aging and dementia.
• Accurate prediction of dementia progression in MCI patients is crucial for timely intervention.
• Existing risk prediction models often lack validation in diverse clinical settings.

Purpose of the Study:

• To develop and validate a 3-year dementia risk score for individuals with MCI.
• To utilize variables commonly collected in routine clinical care for the risk score.
• To assess the score's predictive performance in independent validation cohorts.

Main Methods:

• The Mild Cognitive Impairment to Dementia Risk (CIDER) score was developed using data from the National Alzheimer's Coordinating Center (NACC).
• Cox models were employed for prediction and validated using the Prospective Registry of Persons with Memory Symptoms (PROMPT) and Alzheimer's Disease Neuroimaging Initiative (ADNI) databases.
• Inclusion criteria focused on individuals aged 55 years and older with MCI.

Main Results:

• The CIDER score demonstrated good predictive accuracy, with c-indices of 0.69 (internal validation), 0.61 (PROMPT), and 0.72 (ADNI).
• The score showed consistent performance across internal and external validation cohorts.
• Confidence intervals indicated statistically significant predictive power.

Conclusions:

• The CIDER score provides a reliable tool for estimating 3-year dementia risk in MCI patients.
• This score can inform clinical decision-making and patient counseling regarding dementia progression.
• The CIDER score's validation in multiple cohorts supports its potential for broad clinical application.