A point-based cognitive impairment scoring system for Southeast Asian adults short title: Cognitive impairment scoring system

Authors

Wei Ying Tan, Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Tahir Foundation Building, 12 Science Drive 2 117549, Singapore.
Xiangyuan Huang, Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Tahir Foundation Building, 12 Science Drive 2 117549, Singapore.
Caroline Robert, Department of Pharmacology, National University of Singapore, Singapore. 18 Science Drive 4 117559, Singapore; Memory Aging and Cognition Center, National University Health System, Singapore. National University Health System Tower Block, 1E Kent Ridge Road Level 11 119228, Singapore.
Mervin Tee, Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Tahir Foundation Building, 12 Science Drive 2 117549, Singapore.
Christopher Chen, Department of Pharmacology, National University of Singapore, Singapore. 18 Science Drive 4 117559, Singapore; Memory Aging and Cognition Center, National University Health System, Singapore. National University Health System Tower Block, 1E Kent Ridge Road Level 11 119228, Singapore.
Gerald Choon Koh, Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Tahir Foundation Building, 12 Science Drive 2 117549, Singapore.
Rob M. van Dam, Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Tahir Foundation Building, 12 Science Drive 2 117549, Singapore; Departments of Exercise and Nutrition Sciences and Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington DC, USA. 950 New Hampshire Ave, NW Washington, DC 20052, USA.
Nagaendran Kandiah, Dementia Research Centre, Lee Kong Chian School of Medicine, Singapore. 11 Mandalay Rd 308232, Singapore.
Saima Hilal, Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Tahir Foundation Building, 12 Science Drive 2 117549, Singapore; Department of Pharmacology, National University of Singapore, Singapore. 18 Science Drive 4 117559, Singapore; Memory Aging and Cognition Center, National University Health System, Singapore. National University Health System Tower Block, 1E Kent Ridge Road Level 11 119228, Singapore. Electronic address: saimahilal@nus.edu.sg.

Document Type

Journal Article

Publication Date

1-23-2025

Journal

The journal of prevention of Alzheimer's disease

DOI

10.1016/j.tjpad.2025.100069

Keywords

Cognitive impairment; Neuroimaging; Point-based scoring; Southeast Asian population; Vascular dementia

Abstract

BACKGROUND: Cognitive impairment is a growing concern in Southeast Asian populations, where the burden of cerebrovascular disease (CeVD) is high. Currently, there is no point-based scoring system for identifying cognitive impairment in these populations. OBJECTIVE: To develop and validate a simple point-based Cognitive Impairment Scoring System (CISS) for identifying individuals with cognitive impairment no dementia (CIND) and concomitant CeVD in Southeast Asian populations. DESIGN: A cross-sectional study using data from two population-based studies. SETTING: Community-based setting in Southeast Asia. PARTICIPANTS: 1,511 Southeast Asian adults (664 with CIND, 44.0 %). MEASURES: Two CISS measures were developed: a basic measure including 11 easily assessable risk factors, and an extended measure incorporating seven additional neuroimaging markers. Performance was evaluated using receiver operating characteristic analysis (AUC) and calibration plots. RESULTS: The AUC for CISS-basic and CISS-extended were 0.81 (95 %CI, 0.76-0.86) and 0.85 (95 %CI, 0.81-0.89), respectively. Calibration plots indicated satisfactory fit for both the basic measure (p=0.82) and the extended measure (p=0.17). The basic measure included age, gender, ethnicity, education, systolic blood pressure, BMI, smoking history, diabetes, hyperlipidemia, stroke history, and mild/moderate depression. The extended measure added neuroimaging markers of CeVD and brain atrophy. CONCLUSION: The CISS provides a quick, objective, and clinically relevant tool for assessing cognitive impairment risk in Southeast Asian populations. The basic measure is suitable for initial community-based screenings, while the extended measure offers higher specificity for probable diagnosis. This point-based system enables rapid estimation of cognitive status without requiring complex calculations, potentially improving early detection and management of cognitive impairment in clinical practice.

APA Citation

Tan, Wei Ying; Huang, Xiangyuan; Robert, Caroline; Tee, Mervin; Chen, Christopher; Koh, Gerald Choon; van Dam, Rob M.; Kandiah, Nagaendran; and Hilal, Saima, "A point-based cognitive impairment scoring system for Southeast Asian adults short title: Cognitive impairment scoring system" (2025). GW Authored Works. Paper 6329.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/6329

Department

Exercise and Nutrition Sciences