The predictive value of Framingham risk score for mild cognitive impairment progress to dementia in middle-aged and elderly patients

doi:10.3877/cma.j.issn.2095-8757.2021.03.005

Abstract

Abstract:

Objective

To explore the predictive value of Framingham risk score for mild cognitive impairment (MCI) progress to dementia in middle-aged and elderly patients.

Methods

331 middle-aged and elderly patients with MCI who completed 3-year follow-up were screened from the Alzheimer’s disease Neuroimaging Initiative database. Baseline data, Framingham risk score, APOE genotype and neuropsychiatric scale scores were collected before and after follow-up. According to the progression of dementia at the end of follow-up, the patients were divided into the dementia conversion group and the non-dementia conversion group. T test or rank sum test was used for single-factor analysis. Then, Logistic regression model was used for multivariate analysis, and ROC curve was used to analyze its predictive value.

Results

At the end of follow-up, 91 patients had progressed to dementia (dementia conversion group) and 240 patients had not progressed to dementia (non-dementia conversion group). Age, systolic blood pressure, Framingham risk score and APOE genotype distribution were significantly different between the two groups (t=2.681, 3.058, 2.132, χ²=22.321; P < 0.05 or 0.01). ADAS-cog, AVLT-delayed recall, LMT, TMTA, TMTB, MMSE, AVLT-immediate recall, CDT, VFT and BNT in dementia conversion group were significantly lower than those in non-dementia conversion group (Z=8.301, -8.933, -9.727, 4.356, 5.555; t=-5.373, -11.040, -3.396, -5.590, -2.785; P < 0.01). APOE genotype and Framingham risk score were significantly correlated with the progression to dementia in middle-aged and elderly MCI patients (OR=2.432, 6.088, 95%CI=1.713-3.453, 1.133-32.707; P < 0.05 or 0.01). The area under the ROC curve for predicting the progression of MCI to dementia by Framingham risk score was 0.582 (95%CI=0.511-0.652), and the Youden index was the highest when the score was 0.2185, and the sensitivity and specificity were 64.8% and 57.1%, respectively.

Conclusion

Framingham risk score is significantly associated with the progression to dementia in middle-aged and elderly MCI patients, and it has certain predictive value.

Key words: Mild cognitive impairment, Dementia, Framingham risk score, APOE genotype

Liying Zhuang, Qilun Lai, Lu Liu, Yue Lou, Shanhu Xu, Yu Jin, Xiaoli Liu. The predictive value of Framingham risk score for mild cognitive impairment progress to dementia in middle-aged and elderly patients[J]. Chinese Journal of Geriatrics Research(Electronic Edition), 2021, 08(03): 20-23.

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References 18

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指标	MCI痴呆转化组（n=91）	非痴呆转化组（n=240）	检验值	P值
年龄（年）	55~74（68.44±4.90）	55~74（66.86±4.75）	t=2.681	<0.01
性别（男/女，例）	48/43	138/102	χ²=0.605	>0.05
教育年限（年）	8~20（15.82±2.75）	8~20（16.28±2.64）	t=-1.397	>0.05
收缩压（mmHg）	100~175（135.10±15.28）	90~189（128.62±17.89）	t=3.058	<0.01
体重指数（kg/m²）	18.47~48.59（26.84±5.21）	17.85~48.39（27.58±4.71）	t=-1.241	>0.05
降压治疗（是/否，例）	30/61	92/148	χ²=0.816	>0.05
抽烟（是/否，例）	4/87	25/225	χ²=2.693	>0.05
糖尿病（是/否，例）	12/79	27/213	χ²=0.238	>0.05
高脂血症（是/否，例）	43/48	97/143	χ²=1.263	>0.05
Framingham风险评分	0.27±0.16	0.23±0.14	t=2.132	<0.05

指标	MCI痴呆转化组（n=91）	非痴呆转化组（n=240）	检验值	P值
年龄（年）	55~74（68.44±4.90）	55~74（66.86±4.75）	t=2.681	<0.01
性别（男/女，例）	48/43	138/102	χ²=0.605	>0.05
教育年限（年）	8~20（15.82±2.75）	8~20（16.28±2.64）	t=-1.397	>0.05
收缩压（mmHg）	100~175（135.10±15.28）	90~189（128.62±17.89）	t=3.058	<0.01
体重指数（kg/m²）	18.47~48.59（26.84±5.21）	17.85~48.39（27.58±4.71）	t=-1.241	>0.05
降压治疗（是/否，例）	30/61	92/148	χ²=0.816	>0.05
抽烟（是/否，例）	4/87	25/225	χ²=2.693	>0.05
糖尿病（是/否，例）	12/79	27/213	χ²=0.238	>0.05
高脂血症（是/否，例）	43/48	97/143	χ²=1.263	>0.05
Framingham风险评分	0.27±0.16	0.23±0.14	t=2.132	<0.05

指标	痴呆转化组（n=91）	非痴呆转化组（n=240）	检验值	P值
ADAS-Cog	12（9，16）	7（5，11）	Z=8.301	<0.01
MMSE	27.16±1.71	28.25±1.61	t=-5.373	<0.01
AVLT即刻记忆	29.27±7.12	40.73±11.15	t=-11.040	<0.01
AVLT延迟回忆	1（0，3）	5（3，9）	Z=-8.933	<0.01
LMT	3（1，4）	8（5，10）	Z=-9.727	<0.01
CDT	4.13±1.11	4.56±0.74	t=-3.396	<0.01
TMTA	37（30，50）	31（26，39）	Z=4.356	<0.01
TMTB	98（76，151）	73（60，99）	Z=5.555	<0.01
VFT	15.92±4.44	19.29±5.06	t=-5.590	<0.01
BNT	25.66±3.66	26.93±3.78	t=-2.785	<0.01
GDS	2（1，3）	1（1，3）	Z=1.490	>0.05

指标	痴呆转化组（n=91）	非痴呆转化组（n=240）	检验值	P值
ADAS-Cog	12（9，16）	7（5，11）	Z=8.301	<0.01
MMSE	27.16±1.71	28.25±1.61	t=-5.373	<0.01
AVLT即刻记忆	29.27±7.12	40.73±11.15	t=-11.040	<0.01
AVLT延迟回忆	1（0，3）	5（3，9）	Z=-8.933	<0.01
LMT	3（1，4）	8（5，10）	Z=-9.727	<0.01
CDT	4.13±1.11	4.56±0.74	t=-3.396	<0.01
TMTA	37（30，50）	31（26，39）	Z=4.356	<0.01
TMTB	98（76，151）	73（60，99）	Z=5.555	<0.01
VFT	15.92±4.44	19.29±5.06	t=-5.590	<0.01
BNT	25.66±3.66	26.93±3.78	t=-2.785	<0.01
GDS	2（1，3）	1（1，3）	Z=1.490	>0.05

预测因素	回归系数（B）	标准误	Wald值	OR值	95%CI	P值
Framingham风险评分	1.806	0.858	4.433	6.088	1.133-32.707	<0.05
APOE基因型	0.889	0.179	24.732	2.432	1.713-3.453	<0.01
常量	-2.100	0.302	48.224	0.122	-	<0.01

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