使用多因素预测模型估计痴呆症风险
Mika Kivimäki1,2, Gill Livingston1, Archana Singh-Manoux1,3
1Department of Mental Health of Older People, UCL Brain Sciences, University College London, London, United Kingdom.
目前的痴呆风险评分显示临床价值有限,大多数病例缺失,错误率高. 年龄本身往往表现更好,突出了需要改进痴呆风险预测算法.
科学领域:
- 老年学是一门学科.
- 流行病学 流行病学
- 神经学 神经学
背景情况:
- 评估痴呆风险对于早期干预和预防策略至关重要.
- 现有的多因素算法用于个性化痴呆风险评估,其临床效用尚不清楚.
研究的目的:
- 评估四个广泛使用的痴呆风险得分在估计10年痴呆风险的临床价值.
- 为了比较这些得分的预测准确度与仅仅年龄.
主要方法:
- 基于人口的前性队列研究 (英国生物银行) 和复制队列 (惠特霍尔II研究).
- 评估了四个痴呆症风险得分:CAIDE-临床,CAIDE-APOE,BDSI和ANU-ADRI.
- 通过链接电子健康记录确定痴呆症;分析一致性统计数据,检测率和错误阳性率.
主要成果:
- 所有四个风险分数都显示出高错误率,当校准为5%的错误阳性率时,失踪的痴呆病例为84%-91%.
- 仅仅年龄就显示出比所有测试的风险得分 (范围从0.59到0.73) 的统计一致率更高 (0.79).
- 在同龄参与者的子组分析中,歧视能力较低.
结论:
- 由于错误率很高,现有的痴呆风险预测得分对于识别个人进行痴呆预防具有有限的价值.
- 进一步的研究对于开发更准确的痴呆风险估计算法至关重要.
- 年龄仍然是一个重要的预测因素,但需要改进的多因素模型.
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