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Updated: Sep 17, 2025

A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
Validating Community for Successful Ageing (ComSA) BioPsychoSocial Risk Screener Version II (BPS-RS II) with Diverse
Su Aw1,2, Farah Shiraz3, Hubertus J M Vrijhoef4
1Saw Swee Hock School of Public Health, National University of Singaporeand, National University Health Systems, Singapore, Singapore. awsu@nus.edu.sg.
Background:
Accurately assessing biopsychosocial risk and vulnerability are the building blocks for better interventions and tailoring care for older people.
Methods:
Building on the previously published Community for Successful Ageing (ComSA) BioPsychoSocial Risk Version I Screener (BPS-RS I), we report a re-specified version (BPS-RS II) derived from interviews with older people (n = 40) in Singapore. A cross-sectional survey (n = 1,107) and Factor Analysis (FA) were used to identify items for BPS-RS II. Associations with health-related and quality of life (QoL) and comparisons to Version I were examined.
Results:
Fourteen questions generated from the qualitative findings clustered above the stipulated Kaiser-Meyer-Olkin (KMO) value of greater than 0.5. FA retained the BPS three factor structure. Items in the B domain were largely consistent with Version I, though new items in the P and S domains were identified. Adjusted multi-variate regression analyses replicated additive dose response effects found in BPS-RS I, with smoother gradients and narrower Confidence Intervals (CIs). Stronger associations with Length of Hospital Stay and QoL were detected in BPS-RS II compared to BPS-RS I for participants with BPS risk consisting of having 'overwhelming problems'. The relationship between this category and poor QoL was particularly evident (OR of 39.20, 95% CI: 37.73-40.66, p < 0.01) compared to no BPS risk.
Conclusions:
Using BPS-RS II over I is recommended for biopsychosocial risk assessment and stratifying older people to interventions for population health management. The updated tool is theory-based, culturally sensitive to multi-ethnic contexts in Singapore, and shows improved associations with health-related outcomes, and strong associations with QoL.
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