Development and Validation of a Nomogram for Predicting Cognitive Impairment in Older Adults with Multimodal Sensory...

Sensory impairments across multiple modalities, including vision, hearing, smell, and taste, are critically linked to cognitive dysfunction in older adults. This study aimed to develop and validate a nomogram to assess cognitive impairment (CI) risk specifically among older Americans with diverse sensory disabilities.

We analyzed data from 2,897 participants (aged ≥60 years) from the 2011-2014 National Health and Nutrition Examination Survey (NHANES). Sensory disability was defined as the presence of impairment in at least one of four modalities: vision, hearing, olfaction, or taste. Predictors were identified via least absolute shrinkage and selection operator regression and multivariable logistic regression. Model performance was evaluated using the area under the curve (AUC), calibration plots, and decision curve analysis (DCA).

Participants were randomly partitioned into a training set (n = 2,317) and a validation set (n = 580). The final nomogram incorporated ten key predictors: age, sex, race, education, poverty-income ratio, physical activity (PA), total fat intake, depression, cardiovascular disease, and antihistamine use. The model achieved high discriminative power, with AUCs of 0.818 (95% CI: 0.804-0.832) and 0.816 (95% CI: 0.778-0.851) in the training and validation cohorts, respectively. Calibration curves demonstrated strong agreement between predicted and observed outcomes, while DCA confirmed the model's significant clinical utility for early risk assessment.

This novel nomogram provides a precise and accessible tool for predicting CI in older adults with sensory deficits across multiple modalities. By integrating readily available demographic and clinical factors, the model facilitates early risk stratification and supports the development of targeted preventive strategies in geriatric public health.