Journal Article

Population-based dementia prediction model using Korean public health examination data: A cohort study

Namkoong, Kee, Kim, Woo Jung, An, Suk Kyoon, Chang, Hyuk-Jae, Park, Kyung Mee, Lee, Eun, Sung, Ji Min

2019

Overview

The early identification and prevention of dementia is important for reducing its worldwide burden and increasing individuals' quality of life. Although several dementia prediction models have been developed, there remains a need for a practical and precise model targeted to middle-aged and Asian populations. Here, we used national Korean health examination data from adults (331,126 individuals, 40-69 years of age, mean age: 52 years) from 2002-2003 to predict the incidence of dementia after 10 years. We divided the dataset into two cohorts to develop and validate of our prediction model. Cox proportional hazards models were used to construct dementia prediction models for the total group and sex-specific subgroups. Receiver operating characteristics curves, C-statistics, calibration plots, and cumulative hazards were used to validate model performance. Discriminative accuracy as measured by C-statistics was 0.81 in the total group (95% confidence interval (CI) = 0.81 to 0.82), 0.81 in the male subgroup (CI = 0.80 to 0.82), and 0.81 in the female subgroup (CI = 0.80 to 0.82). Significant risk factors for dementia in the total group were age; female sex; underweight; current hypertension; comorbid psychiatric or neurological disorder; past medical history of cardiovascular disease, diabetes mellitus, or hypertension; current smoking; and no exercise. All identified risk factors were statistically significant in the sex-specific subgroups except for low body weight and current hypertension in the female subgroup. These results suggest that public health examination data can be effectively used to predict dementia and facilitate the early identification of dementia within a middle-aged Asian population.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adult / Adults / Age / Aged / Alzheimer's disease / Analysis / Behavioral sciences / Biology and Life Sciences / Blood pressure / Body mass index / Body weight / Calibration / Cardiology / Cardiovascular diseases / Cohort analysis / Cohort Studies / Comorbidity / Confidence intervals / Dementia / Dementia - epidemiology / Dementia disorders / Diabetes / Diabetes mellitus / Disease prevention / Female / Hazards / Health risk assessment / Health risks / Hospitals / Humans / Hypertension / Incidence / Male / Medical screening / Medicine / Medicine and Health Sciences / Middle age / Middle Aged / Model accuracy / Nervous system diseases / Neurological diseases / Obesity / Older people / Physical Sciences / Population / Population-based studies / Prediction models / Proportional Hazards Models / Psychiatry / Public Health / Quality of life / Republic of Korea - epidemiology / Research and Analysis Methods / Risk analysis / Risk Assessment / Risk Factors / Sex / Smoking / Statistical analysis / Statistical models / Statistics / Studies / Subgroups / Surveys and Questionnaires / Systematic review / Underweight