ANU-ADRI and not Genetic Risk score predicts MCI in a cohort of older adults followed for 12 years
AbstractO_ST_ABSINTRODUCTIONC_ST_ABSWe evaluated a risk score comprising lifestyle, medical and demographic factors (ANU-ADRI), and a genetic risk score (GRS) as predictors of Mild Cognitive Impairment (MCI).\n\nMETHODSANU-ADRI risk scores were computed for the baseline assessment of 2,078 participants from the PATH project. Participants were assessed for clinically diagnosed MCI/Dementia and psychometric test-based MCI (MCI-TB) at 12 years of follow-up. Multi-state models estimated the odds of transitioning from cognitively normal (CN) to MCI/Dementia and MCI-TB over 12 years according to baseline ANU-ADRI and GRS.\n\nRESULTSHigher ANU-ADRI score predicted transitioning from CN to either MCI/Dementia and MCI-TB (Hazard ratio [HR] = 1.06, 95% CI:1.04-1.09; HR = 1.06, 95% CI: 1.03-1.09), and a reduced likelihood of cognitive recovery from MCITB to CN (HR = 0.69, 95% CI: 0.49-0.98). GRS was not associated with transition to MCI/Dementia, or MCI-TB.\n\nDISCUSSIONThe ANU-ADRI may be used for population-level risk assessment and screening.\n\nResearch in ContextO_ST_ABSSystematic ReviewC_ST_ABSThe authors reviewed the literature using online databases e.g. (PubMed). We consulted mild cognitive impairment (MCI) and Alzheimers disease (AD) research detailing the use of risk factors for predicting progression from MCI and AD; and the appropriate statistical models for modelling transitions between cognitive states. These publications are appropriately cited.\n\nInterpretationIn the general population, the ANU-ADRI comprising lifestyle, medical and demographic factors is predictive of progression from normal cognition to MCI/Dementia whereas a Genetic Risk Score comprising the main Alzheimers risk genes is not predictive.\n\nFuture DirectionsFurther evaluation of the ANU-ADRI as a predictor of specific MCI and dementia subtypes is required. The ANU-ADRI may be used to identify individuals indicated for risk reduction intervention and to assist clinical management and cognitive health promotion. Genetic risk scores contribute to understanding dementia etiology but apart from APOE are unlikely to be useful in screening or prevention trials.