Predicting Late Life Dementia Risk With New Index

Normal 0 MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman";} PredictingLate Life Dementia Risk With New Index   Studies in Finland a number of years back, identifieda number of risk factors amongst middle aged people that increased theirchances of future cognitive decline. Now comes a study published in the journal Neurology , Volume 73, Issue 3 (July 2009), entitled: “Predicting riskof dementia in older adults: The late-life dementia risk index” .    Theresearchers led by D.E. Barnes, PhD, developed what appears to be a highlyaccurate risk index that is able to segregate older adults into groups that areat low, moderate, or high risk of developing dementia. There index consists oftwelve factors, with either one or two points given for each. From adding upall the points (possible total of 15) an overall risk assessment can then beassigned. Here are the factors and point values:   Age 75-79years                                                1 Age 80-100years                                               2 LowModified MMSE score                                 2 Low DigitSymbol Substitution Test Score          2 Body MassIndex <18.5                                      2 1 or moreAPOE e4 alleles                                 1 MRI : white matter disease                                  1 MRI : enlarged ventricles                                     1 Internalcarotid artery thickness >2.2 mm          1 History ofcoronary artery bypass                      1 Time to puton and button shirt > 45 sec            1 Lack ofalcohol consumption                             1   Theirfindings based on data from more than 3,000 community dwelling adults aged 65or older, was that among subjects with low scores (0-3), about 4% developeddementia during the next 6 years. Moderate scores (4-7) were associated with a6-year dementia risk of 23%, and 56% of subjects with high scores (≥8)developed dementia. Among those subjects who acquired dementia (n = 480 or14%), 245 had Alzheimer disease, 62 had vascular dementia, 151 had mixeddementia, and 22 had other forms of dementia.   Withouthashing through the Finnish mid-life dementia risk index, suffice to say thatthere are a couple of striking differences between the two indexes. Onemid-life risk factor is obesity, whereas amongst older adults the opposite(being excessively thin) seems to increase risk of dementia. Another difference(although not really - simply a different manifestation) is that the mid-liferisk index incorporates cholesterol levels and blood pressure as factors,whereas the older adult index no longer focuses on those actual numbers.  Inactuality the index does incorporate those factors, but because of age, thedamage from high cholesterol and high blood pressure is assessed instead;namely,   artery bypass, enlarged ventricles, and plugged carotidarteries.    Now, someof these parameters are not typically or easily measured during a routinephysical exam. MRI ’s and APOE gene status would typically not be assessedunless symptoms were present. These risk “scores” estimate the probability ofdeveloping dementia but in no way can predict which person definitively willsuffer cognitive impairment. However, it can be a useful tool in identifyingpersons that would be most likely to benefit from preventive interventions andalert patients and physicians alike that certain steps should be taken toimprove some of the risk factors to lower the probability of developingdementia.   And yes,that was not a typo, not drinking alcohol does raise the risk of dementia.   As alwaysconsult your physician or health care practitioner in all these matters thatimpact your health, seek corroboration of information, and most of all, educateyourself. Andre Baran IV and his brother Bernard Baran, are co-owners of BrothersNutrition.com ( http://www.brothersnutrition.com ) as well as Brothers Nutrition in Edgewater, Florida..  They can be reached with questions or comments via e-mail at edge@brothersnutrition.com .  

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