Tool Predicts Age at Cognitive Impairment, Dementia Onset: Daily Dose

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On January 16, 2025, we reported on a study published in JAMA Network Open that was designed to assess whether the age at onset of mild cognitive impairment (MCI) and Alzheimer dementia (AD) can be predicted using a statistical modeling approach.

The study

Researchers conducted the prognostic study using data from 2 aging and dementia cohort studies for model development and validation of the Florey Dementia Index (FDI), a novel tool used to predict the age at onset of MCI and AD in older adults. They used data from 1665 participants in the Australian Imaging, Biomarker, and Lifestyle (AIBL) study and 2029 people in the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Data were collected from October 2004 to March 2023. All participants were aged 60 years and older and had at least 2 records of CDR-SB scores. People with MCI or dementia from non-Alzheimer causes were not included in the study.

Data was also collected from 93 participants in the the Anti-Amyloid Treatment in Asymptomatic Alzheimer (A4) study for a simulated trial. Unlike AIBL and ADNI, the A4 study consisted of people with elevated amyloid-beta and normal cognition.

The findings

The FDI demonstrated strong predictive performance, with a mean absolute error (MAE) of 2.78 years (95% CI, 2.63-2.93) for MCI and 1.48 years (95% CI, 1.32-1.65) for AD. In the simulated trial with A4 participants, the FDI showed MAEs of 1.57 years (95% CI, 1.41-1.71) for predicting MCI onset and 0.70 years (95% CI, 0.53-0.88) for predicting the onset of AD.

Authors' comments

"The promising results achieved in the present study support the potential clinical use of the FDI model so that timely diagnostics, treatment, and care plans for individuals at risk can be arranged. Our developed prototype application for the FDI, once validated, can be readily used by clinicians without any prior knowledge in statistics."

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