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Memory and thinking tests lift dementia-risk prediction far more than scans or spinal-fluid markers
We built a risk model for who with mild impairment would develop dementia and tested it on 297 people it had never seen. Using age, sex, education and APOE4 alone, the model ranked people correctly about 64 times in 100 (0.635, where 0.5 is a coin toss). Adding memory and thinking tests raised this to about 85 in 100 (0.847). Adding spinal-fluid markers, brain MRI and amyloid/glucose PET on top moved it by less than one point each (0.855, 0.860, 0.863), and every one of those gains is within chance.
| Measure | Value | n |
|---|---|---|
| Age/sex/education/APOE4 only (concordance) | 0.635 (0.577-0.686) | 297 |
| + cognitive tests | 0.847 (0.812-0.877) | 297 |
| + spinal fluid | 0.855 (0.822-0.882) | 297 |
| + MRI | 0.860 (0.829-0.888) | 297 |
| + amyloid PET and glucose PET | 0.863 (0.832-0.890) | 297 |
Caveat. Several of the cognitive tests are used by clinicians to decide the dementia diagnosis itself, which flatters their predictive power.
Source report: /home/arodrig5/adni_pipeline/out/cognitive.md