Nontraditional risk factors combine to predict Alzheimer disease and dementia
Open accessAbstract
OBJECTIVE: To investigate whether dementia risk can be estimated using only health deficits not known to predict dementia. METHODS: A frailty index consisting of 19 deficits not known to predict dementia (the nontraditional risk factors index [FI-NTRF]) was constructed for 7,239 cognitively healthy, community-dwelling older adults in the Canadian Study of Health and Aging. From baseline, their 5-year and 10-year risks for Alzheimer disease (AD), dementia of all types, and survival were estimated. RESULTS: The FI-NTRF was closely correlated with age (r2 > 0.96, p < 0.001). The incidence of AD and dementia increased exponentially with the FI-NTRF (r2 > 0.75, p < 0.001 over 10 years). Adjusted for age, sex, education, and baseline cognition, the odds ratio of dementia increased by 3.2% (p = 0.021) for each deficit (that was not known to predict dementia) accumulated, outperforming the individual cognitive risk factors. The FI-NTRF discriminated people with AD and all-cause dementia from those who were cognitively healthy with an area under the receiver operating characteristic curve of 0.66 ± 0.03. CONCLUSIONS: Comprehensive re-evaluation of a well-characterized cohort showed that age-associated decline in health status, in addition to traditional risk factors, is a risk factor for AD and dementia. General health may be an important confounder to consider in dementia risk factor evaluation. If a diverse range of deficits is associated with dementia, then improving general health might reduce dementia risk.
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Two large prospective cohorts have reported an independent link between frailty and dementia.
“An independent association between frailty and dementia has been reported in two large prospective cohort studies (31, 32).”
From Frailty in elderly people (2013) · cites this paper as [32]
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- Authors
- Song, X., Mitnitski, A., & Rockwood, K.
- Affiliations
- Dalhousie University (CA)
- Corresponding author
- Rockwood, Kenneth
- Venue
- Neurology
- Published
- 2011-07-19
- Volume
- 77
- Issue
- 3
- Pages
- 227-234
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- PMC
- PMC3136058
- OpenAlex
- W2152512271
- Cited by
- 220
- References
- 33
- Citations by year
- 2026: 9 · 2025: 9 · 2024: 10 · 2023: 16 · 2022: 8 · 2021: 14 · 2020: 19 · 2019: 16 · 2018: 15 · 2017: 12 · 2016: 19 · 2015: 18 · 2014: 24 · 2013: 15 · 2012: 8
- FWCI
- 12.11
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Neurology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- NPARC (acceptedVersion)
- Funders
- Bristol-Myers Squibb
- Pfizer
- Dalhousie Medical Research Foundation
- University of Ottawa
- Alzheimer's Society
- Alzheimer Society
- Nova Scotia Health Research Foundation
- National Natural Science Foundation of China
- Dalhousie University
- Elan
- Eisai
- Health Canada
- Canadian Institutes of Health Research (MOP 209888)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- Alzheimer's disease, dementia, frailty index, non-traditional risk factors, health deficits, dementia risk prediction, older adults, community-dwelling adults, all-cause mortality, cognitive decline, Canadian Study of Health and Aging
- MeSH terms
- Age Factors, Aged, Aged, 80 and over, Alzheimer Disease, Canada, Cognition, Dementia, Educational Status, Female, Humans, Longitudinal Studies, Male, Middle Aged, Retrospective Studies, Risk Factors, Incidence, Logistic Models
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