Methodological reflections on a nutritional status-based nomogram for predicting cognitive impairment in elderly hypertensive patients
Related Experiment Video
Updated: Jan 14, 2026

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Abdul Rauf Khalid1, Abdulqadir J Nashwan2
1Medical Officer, Bahria International Hospital Orchard, Lahore 54000, Punjab, Pakistan.
Abstract:
This letter critiques the article by Xu et al in World Journal of Psychiatry, which developed a nomogram to predict cognitive impairment in elderly hypertensive patients using nutritional and biochemical parameters. While the model's use of variables like body mass index, albumin, hemoglobin, alkaline phosphatase, and mini-nutritional assessment scores is promising, we raise concerns about the small validation cohort size, potential reverse causality in cross-sectional data, insufficiently discussed mechanisms for alkaline phosphatase as a risk factor, omission of key cognitive predictors, and possible overfitting given high area under the curve values. We suggest external validation, longitudinal studies, and calibration metrics to enhance the model's robustness and clinical utility.
More Related Videos
Related Concept Videos
Drug Dosing: Geriatric Patients
Dosage Regimen Designs: Nomograms and Tabulations
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
Cognitive Development During Adulthood
Hypertension V: Nursing Management
Hypertension III: Clinical Manifestations and Diagnostic Studies

