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Predicting incident dementia 3-8 years after brief cognitive tests in the UK Biobank prospective study of 500,000 people

  • Catherine M. Calvin
    Correspondence
    Corresponding author. Tel.: +44 (0)1865 613103; Fax: +44 (0)1865 793101
    Affiliations
    Dementias Platform UK, Department of Psychiatry, University of Oxford Warneford Hospital, Oxford, UK

    Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE), Department of Psychology, University of Edinburgh, Edinburgh, UK
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  • Tim Wilkinson
    Affiliations
    Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK

    Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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  • Author Footnotes
    † Deceased 8 December 2018.
    John M. Starr
    Footnotes
    † Deceased 8 December 2018.
    Affiliations
    Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE), Department of Psychology, University of Edinburgh, Edinburgh, UK

    Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK
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  • Cathie Sudlow
    Affiliations
    Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK

    Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK

    UK Biobank, Cheadle, Stockport, UK
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  • Saskia P. Hagenaars
    Affiliations
    Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE), Department of Psychology, University of Edinburgh, Edinburgh, UK

    Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, Denmark Hill, London, UK

    NIHR Biomedical Research Centre, South London and Maudsley NHS Trust, London, UK
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  • Sarah E. Harris
    Affiliations
    Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE), Department of Psychology, University of Edinburgh, Edinburgh, UK

    University of Edinburgh Centre for Genomic and Experimental Medicine and MRC Institute of Genetics and Molecular Medicine, Western General Hospital, Edinburgh, UK
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  • Christian Schnier
    Affiliations
    Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
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  • Gail Davies
    Affiliations
    Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE), Department of Psychology, University of Edinburgh, Edinburgh, UK
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  • Chloe Fawns-Ritchie
    Affiliations
    Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE), Department of Psychology, University of Edinburgh, Edinburgh, UK
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  • Catharine R. Gale
    Affiliations
    Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE), Department of Psychology, University of Edinburgh, Edinburgh, UK
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  • John Gallacher
    Affiliations
    Dementias Platform UK, Department of Psychiatry, University of Oxford Warneford Hospital, Oxford, UK
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  • Ian J. Deary
    Affiliations
    Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE), Department of Psychology, University of Edinburgh, Edinburgh, UK
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  • Author Footnotes
    † Deceased 8 December 2018.
Published:October 13, 2019DOI:https://doi.org/10.1016/j.jalz.2019.07.014

      Abstract

      Introduction

      Prospective studies reporting associations between cognitive performance and subsequent incident dementia have been subject to attrition bias. Furthermore, the extent to which established risk factors account for such associations requires further elucidation.

      Methods

      We used UK Biobank baseline cognitive data (n ≤ 488,130) and electronically linked hospital inpatient and death records during three- to eight-year follow-up, to estimate risk of total dementia (n = 1051), Alzheimer's disease (n = 352), and vascular dementia (n = 169) according to four brief cognitive tasks, with/without adjustment for constitutional and modifiable risk factors.

      Results

      We found associations of cognitive task performance with all-cause and cause-specific dementia (P <  .01); these were not accounted for by established risk factors. Cognitive data added up to 5% to the discriminative accuracy of receiver operating characteristic curve models; areas under the curve ranged from 82% to 86%.

      Discussion

      This study offers robust evidence that brief cognitive testing could be a valuable addition to dementia prediction models.

      Keywords

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