Brian Downer1, Amit Kumar2, Sreenivas P Veeranki3, Hemalkumar B Mehta4, Mukaila Raji5, Kyriakos S Markides3. 1. Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, Texas. 2. Center for Gerontology and Healthcare Research, Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, Rhode Island. 3. Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas. 4. Department of Surgery, University of Texas Medical Branch, Galveston, Texas. 5. Division of Geriatrics, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas.
Abstract
OBJECTIVES: To create a risk index (Mexican American Dementia Nomogram (MADeN)) that predicts dementia over a 10-year period for Mexican Americans aged 65 and older. DESIGN: Retrospective cohort study with longitudinal analysis. SETTING: Texas, New Mexico, Colorado, Arizona, and California. PARTICIPANTS: Hispanic Established Populations for the Epidemiologic Study of the Elderly (H-EPESE) participants (n = 1,739). MEASUREMENTS: Dementia was defined as a decline of three or more points per year on the Mini-Mental State Examination and inability to perform one or more daily activities. Candidate risk factors included demographic characteristics, measures of social engagement, self-reported health conditions, ability to perform daily activities, and physical activity. RESULTS: The MADeN comprised the following risk factors: age, sex, education, not having friends to count on, not attending community events, diabetes mellitus, feeling the blues, pain, impairment in instrumental activities of daily living, and unable to walk a half-mile. The area under the receiver operating characteristic curve was 0.74 (95% confidence interval (CI) = 0.70-0.78) and a score of 16 points or higher had a sensitivity of 0.65 (95% CI = 0.59-0.72) and specificity of 0.70 (95% CI = 0.67-0.73) in predicting dementia. CONCLUSION: The MADeN was able to predict dementia in a population of older Mexican-American adults with moderate accuracy. It has the potential to identify older Mexican-American adults who may benefit from interventions to reduce dementia risk and to educate this population about risk factors for dementia.
OBJECTIVES: To create a risk index (Mexican American Dementia Nomogram (MADeN)) that predicts dementia over a 10-year period for Mexican Americans aged 65 and older. DESIGN: Retrospective cohort study with longitudinal analysis. SETTING: Texas, New Mexico, Colorado, Arizona, and California. PARTICIPANTS: Hispanic Established Populations for the Epidemiologic Study of the Elderly (H-EPESE) participants (n = 1,739). MEASUREMENTS: Dementia was defined as a decline of three or more points per year on the Mini-Mental State Examination and inability to perform one or more daily activities. Candidate risk factors included demographic characteristics, measures of social engagement, self-reported health conditions, ability to perform daily activities, and physical activity. RESULTS: The MADeN comprised the following risk factors: age, sex, education, not having friends to count on, not attending community events, diabetes mellitus, feeling the blues, pain, impairment in instrumental activities of daily living, and unable to walk a half-mile. The area under the receiver operating characteristic curve was 0.74 (95% confidence interval (CI) = 0.70-0.78) and a score of 16 points or higher had a sensitivity of 0.65 (95% CI = 0.59-0.72) and specificity of 0.70 (95% CI = 0.67-0.73) in predicting dementia. CONCLUSION: The MADeN was able to predict dementia in a population of older Mexican-American adults with moderate accuracy. It has the potential to identify older Mexican-American adults who may benefit from interventions to reduce dementia risk and to educate this population about risk factors for dementia.
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