A point-based cognitive impairment scoring system for southeast Asian adults
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Published on: January 11, 2020
Wei Ying Tan1, Xiangyuan Huang1, Caroline Robert2
1Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Tahir Foundation Building, 12 Science Drive 2 117549, Singapore.
Background:
Cognitive impairment is a growing concern in Southeast Asian populations, where the burden of cerebrovascular disease (CeVD) is high. Currently, there is no point-based scoring system for identifying cognitive impairment in these populations.
Objective:
To develop and validate a simple point-based Cognitive Impairment Scoring System (CISS) for identifying individuals with cognitive impairment no dementia (CIND) and concomitant CeVD in Southeast Asian populations.
Design:
A cross-sectional study using data from two population-based studies.
Setting:
Community-based setting in Southeast Asia.
Participants:
1,511 Southeast Asian adults (664 with CIND, 44.0 %).
Measures:
Two CISS measures were developed: a basic measure including 11 easily assessable risk factors, and an extended measure incorporating seven additional neuroimaging markers. Performance was evaluated using receiver operating characteristic analysis (AUC) and calibration plots.
Results:
The AUC for CISS-basic and CISS-extended were 0.81 (95 %CI, 0.76-0.86) and 0.85 (95 %CI, 0.81-0.89), respectively. Calibration plots indicated satisfactory fit for both the basic measure (p=0.82) and the extended measure (p=0.17). The basic measure included age, gender, ethnicity, education, systolic blood pressure, BMI, smoking history, diabetes, hyperlipidemia, stroke history, and mild/moderate depression. The extended measure added neuroimaging markers of CeVD and brain atrophy.
Conclusion:
The CISS provides a quick, objective, and clinically relevant tool for assessing cognitive impairment risk in Southeast Asian populations. The basic measure is suitable for initial community-based screenings, while the extended measure offers higher specificity for probable diagnosis. This point-based system enables rapid estimation of cognitive status without requiring complex calculations, potentially improving early detection and management of cognitive impairment in clinical practice.
