Nicola Coley1,2, Marieke P Hoevenaar-Blom3,4, Jan-Willem van Dalen3,4, Eric P Moll van Charante5, Miia Kivipelto6,7,8,9,10, Hilkka Soininen11,12, Sandrine Andrieu1,2, Edo Richard3,4. 1. INSERM-University of Toulouse UMR1027, Toulouse, France. 2. Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France. 3. Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. 4. Department of Neurology, Donders Centre for Brain, Behaviour and Cognition, Radboud University Medical Center, Nijmegen, the Netherlands. 5. Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. 6. Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland. 7. Division of Clinical Geriatrics, Center for Alzheimer Research, Care Sciences and Society (NVS), Stockholm, Sweden. 8. Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden. 9. Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland. 10. Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, United Kingdom. 11. Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland. 12. Neurocenter Finland, Neurology, Kuopio University Hospital, Kuopio, Finland.
Abstract
INTRODUCTION: Although not designed as such, dementia risk scores might be useful surrogate outcomes for dementia prevention trials. Their suitability may be improved by using continuous scoring systems, taking into account all changes in risk factors, not only those crossing cut-off values. METHODS: In three large multidomain dementia prevention trials with 1.5 to 2 years of follow-up (Multidomain Alzheimer Preventive Trial, Prevention of Dementia by Intensive Vascular Care and Healthy Ageing Through Internet Counselling in the Elderly) we assessed (1) responsiveness (sensitivity to change) and (2) actual and simulated intervention effects of the original and crude/weighted z-score versions of the cardiovascular risk factors, aging and incidence of dementia, and Lifestyle for Brain Health scores. RESULTS: All versions of the risk scores were generally responsive, and able to detect small though statistically significant between-group differences after multidomain interventions. Simulated intervention effects were well detected in z-score versions as well as in the original scores. DISCUSSION: Dementia risk scores and their z-score versions show potential as surrogate outcomes. How changes in risk scores affect dementia remains to be determined.
INTRODUCTION: Although not designed as such, dementia risk scores might be useful surrogate outcomes for dementia prevention trials. Their suitability may be improved by using continuous scoring systems, taking into account all changes in risk factors, not only those crossing cut-off values. METHODS: In three large multidomain dementia prevention trials with 1.5 to 2 years of follow-up (Multidomain Alzheimer Preventive Trial, Prevention of Dementia by Intensive Vascular Care and Healthy Ageing Through Internet Counselling in the Elderly) we assessed (1) responsiveness (sensitivity to change) and (2) actual and simulated intervention effects of the original and crude/weighted z-score versions of the cardiovascular risk factors, aging and incidence of dementia, and Lifestyle for Brain Health scores. RESULTS: All versions of the risk scores were generally responsive, and able to detect small though statistically significant between-group differences after multidomain interventions. Simulated intervention effects were well detected in z-score versions as well as in the original scores. DISCUSSION: Dementia risk scores and their z-score versions show potential as surrogate outcomes. How changes in risk scores affect dementia remains to be determined.
Authors: Irene S Heger; Kay Deckers; Miranda T Schram; Coen D A Stehouwer; Pieter C Dagnelie; Carla J H van der Kallen; Annemarie Koster; Simone J P M Eussen; Jacobus F A Jansen; Frans R J Verhey; Martin P J van Boxtel; Sebastian Köhler Journal: Neurology Date: 2021-08-25 Impact factor: 9.910