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

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: APOE ε4; Alzheimer's disease; Cognitive performance; Dementia; Modifiable risk factors; Polygenic risk; ROC; Vascular dementia.