Development, Validation and Field Evaluation of the Singapore Longitudinal Ageing Study (SLAS) Risk Index for Prediction of Mild Cognitive Impairment and Dementia

• Published in: The journal of prevention of Alzheimer's disease 2021, Vol.8 (3), p.335-344
• Main Authors: Ng, Tze Pin, Lee, T. S., Lim, W. S., Chong, M. S., Yap, P., Cheong, C. Y., Yap, K. B., Rawtaer, I., Liew, T. M., Gao, Q., Gwee, X., Ng, M. P. E., Nicholas, S. O., Wee, S. L.
• Format: Article
• Language: English
• Subjects: Geriatrics/Gerontology; Medicine; Medicine & Public Health; Neurology; Original Research
• ISSN: 2426-0266
• DOI: 10.14283/jpad.2021.19

Background Mild cognitive impairment (MCI) is a critical pre-dementia target for preventive interventions. There are few brief screening tools based on self-reported personal lifestyle and health-related information for predicting MCI that have been validated for their generalizability and utility in primary care and community settings. Objective To develop and validate a MCI risk prediction index, and evaluate its field application in a pilot community intervention trial project. Design Two independent population-based cohorts in the Singapore Longitudinal Ageing Study (SLAS). We used SLAS1 as a development cohort to construct the risk assessment instrument, and SLA2 as a validation cohort to verify its generalizability. Setting Community-based screening and lifestyle intervention Participants: (1) SLAS1 cognitively normal (CN) aged ≥55 years with average 3 years (N=1601); (2) SLAS2 cohort (N=3051) with average 4 years of follow up. (3) 437 participants in a pilot community intervention project. Measurements The risk index indicators included age, female sex, years of schooling, hearing loss, depression, life satisfaction, number of cardio-metabolic risk factors (wide waist circumference, pre-diabetes or diabetes, hypertension, dyslipidemia). Weighted summed scores predicted probabilities of MCI or dementia. A self-administered questionnaire field version of the risk index was deployed in the pilot community project and evaluated using pre-intervention baseline cognitive function of participants. Results Risk scores were associated with increasing probabilities of progression to MCI-or-dementia in the development cohort (AUC=0.73) and with increased prevalence and incidence of MCI-or-dementia in the validation cohort (AUC=0.74). The field questionnaire risk index identified high risk individuals with strong correlation with RBANS cognitive scores in the community program (p