A Late Life Risk Index for Severe Cognitive Impairment in Mexico

Brian Downer, Sreenivas P. Veeranki, Rebeca Wong

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Several dementia risk indices have been developed for older adults in high-income countries. However, no index has been developed for populations in low- or middle-income countries. Objective: To create a risk index for predicting severe cognitive impairment among adults aged ≥60 in Mexico and to compare the accuracy of this index to the Dementia Screening Indicator (DSI). Methods: This study included 3,002 participants from the Mexican Health and Aging Study (MHAS) interviewed in 2001 and 2012. The MHAS risk index included sociodemographic, health, and functional characteristics collected in 2001. A point value based on the beta coefficients from a multivariable logistic regression model was assigned to each risk factor and the total score was calculated. Results: The MHAS risk index (AUC = 0.74 95 CI = 0.70-0.77) and DSI (AUC = 0.72 95 CI = 0.69-0.77) had similar accuracy for discriminating between participants who developed severe cognitive impairment from those who did not. A score of ≥16 on the MHAS risk index had a sensitivity of 0.69 (95 CI = 0.64-0.70) and specificity of 0.67 (95 CI = 0.66-0.69). A score of ≥23 on the DSI had a sensitivity of 0.56 (95 CI = 0.50-0.63) and specificity of 0.78 (95 CI = 0.76-0.79). Discussion: The MHAS risk index and DSI have moderate accuracy for predicting severe cognitive impairment among older adults in Mexico. This provides evidence that existing dementia risk indices may be applicable in low- and middle-income countries such as Mexico. Future research should seek to identify additional risk factors that can improve the accuracy of the MHAS risk index.

Original languageEnglish (US)
Pages (from-to)191-203
Number of pages13
JournalJournal of Alzheimer's Disease
Volume52
Issue number1
DOIs
StatePublished - Apr 26 2016

Fingerprint

Mexico
Dementia
Health
Area Under Curve
Logistic Models
Cognitive Dysfunction
Population

Keywords

  • Aging
  • dementia
  • diagnosis
  • Mexico

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Geriatrics and Gerontology
  • Clinical Psychology

Cite this

A Late Life Risk Index for Severe Cognitive Impairment in Mexico. / Downer, Brian; Veeranki, Sreenivas P.; Wong, Rebeca.

In: Journal of Alzheimer's Disease, Vol. 52, No. 1, 26.04.2016, p. 191-203.

Research output: Contribution to journalArticle

@article{1817654161384717a0277127c9cf2134,
title = "A Late Life Risk Index for Severe Cognitive Impairment in Mexico",
abstract = "Background: Several dementia risk indices have been developed for older adults in high-income countries. However, no index has been developed for populations in low- or middle-income countries. Objective: To create a risk index for predicting severe cognitive impairment among adults aged ≥60 in Mexico and to compare the accuracy of this index to the Dementia Screening Indicator (DSI). Methods: This study included 3,002 participants from the Mexican Health and Aging Study (MHAS) interviewed in 2001 and 2012. The MHAS risk index included sociodemographic, health, and functional characteristics collected in 2001. A point value based on the beta coefficients from a multivariable logistic regression model was assigned to each risk factor and the total score was calculated. Results: The MHAS risk index (AUC = 0.74 95 CI = 0.70-0.77) and DSI (AUC = 0.72 95 CI = 0.69-0.77) had similar accuracy for discriminating between participants who developed severe cognitive impairment from those who did not. A score of ≥16 on the MHAS risk index had a sensitivity of 0.69 (95 CI = 0.64-0.70) and specificity of 0.67 (95 CI = 0.66-0.69). A score of ≥23 on the DSI had a sensitivity of 0.56 (95 CI = 0.50-0.63) and specificity of 0.78 (95 CI = 0.76-0.79). Discussion: The MHAS risk index and DSI have moderate accuracy for predicting severe cognitive impairment among older adults in Mexico. This provides evidence that existing dementia risk indices may be applicable in low- and middle-income countries such as Mexico. Future research should seek to identify additional risk factors that can improve the accuracy of the MHAS risk index.",
keywords = "Aging, dementia, diagnosis, Mexico",
author = "Brian Downer and Veeranki, {Sreenivas P.} and Rebeca Wong",
year = "2016",
month = "4",
day = "26",
doi = "10.3233/JAD-150702",
language = "English (US)",
volume = "52",
pages = "191--203",
journal = "Journal of Alzheimer's Disease",
issn = "1387-2877",
publisher = "IOS Press",
number = "1",

}

TY - JOUR

T1 - A Late Life Risk Index for Severe Cognitive Impairment in Mexico

AU - Downer, Brian

AU - Veeranki, Sreenivas P.

AU - Wong, Rebeca

PY - 2016/4/26

Y1 - 2016/4/26

N2 - Background: Several dementia risk indices have been developed for older adults in high-income countries. However, no index has been developed for populations in low- or middle-income countries. Objective: To create a risk index for predicting severe cognitive impairment among adults aged ≥60 in Mexico and to compare the accuracy of this index to the Dementia Screening Indicator (DSI). Methods: This study included 3,002 participants from the Mexican Health and Aging Study (MHAS) interviewed in 2001 and 2012. The MHAS risk index included sociodemographic, health, and functional characteristics collected in 2001. A point value based on the beta coefficients from a multivariable logistic regression model was assigned to each risk factor and the total score was calculated. Results: The MHAS risk index (AUC = 0.74 95 CI = 0.70-0.77) and DSI (AUC = 0.72 95 CI = 0.69-0.77) had similar accuracy for discriminating between participants who developed severe cognitive impairment from those who did not. A score of ≥16 on the MHAS risk index had a sensitivity of 0.69 (95 CI = 0.64-0.70) and specificity of 0.67 (95 CI = 0.66-0.69). A score of ≥23 on the DSI had a sensitivity of 0.56 (95 CI = 0.50-0.63) and specificity of 0.78 (95 CI = 0.76-0.79). Discussion: The MHAS risk index and DSI have moderate accuracy for predicting severe cognitive impairment among older adults in Mexico. This provides evidence that existing dementia risk indices may be applicable in low- and middle-income countries such as Mexico. Future research should seek to identify additional risk factors that can improve the accuracy of the MHAS risk index.

AB - Background: Several dementia risk indices have been developed for older adults in high-income countries. However, no index has been developed for populations in low- or middle-income countries. Objective: To create a risk index for predicting severe cognitive impairment among adults aged ≥60 in Mexico and to compare the accuracy of this index to the Dementia Screening Indicator (DSI). Methods: This study included 3,002 participants from the Mexican Health and Aging Study (MHAS) interviewed in 2001 and 2012. The MHAS risk index included sociodemographic, health, and functional characteristics collected in 2001. A point value based on the beta coefficients from a multivariable logistic regression model was assigned to each risk factor and the total score was calculated. Results: The MHAS risk index (AUC = 0.74 95 CI = 0.70-0.77) and DSI (AUC = 0.72 95 CI = 0.69-0.77) had similar accuracy for discriminating between participants who developed severe cognitive impairment from those who did not. A score of ≥16 on the MHAS risk index had a sensitivity of 0.69 (95 CI = 0.64-0.70) and specificity of 0.67 (95 CI = 0.66-0.69). A score of ≥23 on the DSI had a sensitivity of 0.56 (95 CI = 0.50-0.63) and specificity of 0.78 (95 CI = 0.76-0.79). Discussion: The MHAS risk index and DSI have moderate accuracy for predicting severe cognitive impairment among older adults in Mexico. This provides evidence that existing dementia risk indices may be applicable in low- and middle-income countries such as Mexico. Future research should seek to identify additional risk factors that can improve the accuracy of the MHAS risk index.

KW - Aging

KW - dementia

KW - diagnosis

KW - Mexico

UR - http://www.scopus.com/inward/record.url?scp=84973135879&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84973135879&partnerID=8YFLogxK

U2 - 10.3233/JAD-150702

DO - 10.3233/JAD-150702

M3 - Article

VL - 52

SP - 191

EP - 203

JO - Journal of Alzheimer's Disease

JF - Journal of Alzheimer's Disease

SN - 1387-2877

IS - 1

ER -