The Vulnerability Index: A weighted measure of dementia and cognitive impairment risk

Abstract

Introduction A brief, easily calculated and interpretable index to assess vulnerability to developing cognitive impairment is needed in clinical practice and research. To address this, we developed the Vulnerability Index (VI) with the goal of identifying individuals possessing a high risk for cognitive impairment. Methods Twelve easily obtained sociodemographic, medical, and functional factors were used to develop the VI, with each selectively weighted based on factor analysis and predictive modeling. This cross‐sectional study examined 387 subject‐partner dyads. Results The VI was found to accurately discriminate between cognitively normal controls and participants with cognitive impairment (area under the curve [AUC]: 0.844; 95% confidence interval [CI]: 0.776‐0.913) and individuals scoring high on the VI (≥8) had worse health, functional, behavioral, cognitive, and quality of life ratings than those with lower scores. Discussion The VI could be used in screening asymptomatic individuals for risk of cognitive impairment and guiding the development of primary and secondary prevention plans.

High frequency post-pause word choices and task-dependent speech behavior characterize connected speech in individuals with mild cognitive impairment

“…There was a significant difference in age between the two groups ( p = .003), resulting in age being included as a covariate in all following comparisons ( Table 1 ). No differences between groups were found for gender, years of education, race or ethnicity, vulnerability [51], or resilience [52].…”

Social Determinants of Health, Risk and Resilience against Alzheimer’s Disease and Related Dementias: The Healthy Brain Initiative

“…Total RI scores are calculated by summing the subcomponent scores (range = 1–378; higher scores = greater resilience against dementia). VI is composed of 12 risk factors for dementia: age, biological sex, race and ethnicity, education, frailty (Fried Frailty Index≥2), obesity (>30 kg/m 2 ), depression (Hospital Anxiety and Depression Scale≥8), and self-reported comorbidities (hypercholesterolemia, diabetes, hypertension, heart disease, stroke) [ 40 ] (range = 2–20; higher scores = greater vulnerability to dementia). Other factors such as smoking, alcohol use, and traumatic brain injury were evaluated for inclusion but did not significantly contribute to the predictive model and thus were excluded from the final set of factors used to derive the VI.…”

The Healthy Brain Initiative (HBI): A prospective cohort study protocol

“…The Brain Health Platform (84) quantifies brain health and identifies ADRD risk factors based on 3 measures collected that will be collected at HBI: Resilience Index (RI) (85), the Vulnerability Index (VI) (86); and the Number-Symbol Coding Task (NSCT) (55). VI and RI scores (range: 2-20 and 1-378, respectively) are calculated from demographics, lifestyle questionnaires, physical assessments, medical history, and neuropsychological examination.…”

“…VI and RI scores (range: 2-20 and 1-378, respectively) are calculated from demographics, lifestyle questionnaires, physical assessments, medical history, and neuropsychological examination. Details of the Brain Health Platform including the VI and RI are published elsewhere (85, 86). By combining measures of performance, resilience, and vulnerability, it provides an overall snapshot of the participant’s brain health at a given visit.…”