Development and Validation of a Nomogram for Predicting the 6-Year Risk of Cognitive Impairment Among Chinese Older Adults.
Jinhui Zhou, Yuebin Lv, Chen Mao and 11 others
PMID 32507532WHAT IT FOUND
A simple chart using age, daily function, MMSE, stroke, chewing, vision, TV/radio, and pets estimated six-year cognitive impairment risk in Chinese adults aged 65 and above without baseline impairment and matched observed risk in a second cohort.
Key findings
01The final model used eight variables: age, baseline MMSE, ADL/IADL score, chewing ability, visual function, history of stroke, watching TV or listening to radio, and growing flowers or raising pets.
02Cognitive impairment developed in 18.2% (1828) of the development cohort and 20.7% (1932) of the validation cohort.
03The nomogram had AUC values of 0.891 for internal validation and 0.867 for external validation.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Cognitive impairment was checked only at three-year intervals, so decline between visits may have been missed. Older participants may have died before later cognitive testing, which could leave missing data and affect risk estimates. Important predictors such as APOE ε4, fasting plasma glucose, cerebrospinal fluid biomarkers, HbA1c, and vitamin use were not included. The model was built and validated only in Chinese CLHLS cohorts, and the authors note it may not transfer to well-educated older adults in developed countries. Age drove much of the model's performance; without age, AUCs were lower at 0.821 and 0.781. Cognitive impairment was defined by education-adjusted MMSE cutoffs, not clinical diagnosis.
Declared interests
The article metadata lists research support from NIH extramural and non-U.S. government. The authors declare no conflicts of interest.
The easy way to misread this
Do not read watching TV, listening to radio, or growing flowers and raising pets as proven ways to prevent cognitive impairment. The study found associations in older adults and did not test any intervention.