A point-based cognitive impairment scoring system for southeast Asian adults - 27/03/25

Doi : 10.1016/j.tjpad.2025.100069 
Wei Ying Tan a, Xiangyuan Huang a, Caroline Robert b, c, Mervin Tee a, Christopher Chen b, c, Gerald Choon Huat Koh a, Rob M. van Dam a, d, Nagaendran Kandiah e, Saima Hilal a, b, c,
a Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Tahir Foundation Building, 12 Science Drive 2 117549, Singapore 
b Department of Pharmacology, National University of Singapore, Singapore. 18 Science Drive 4 117559, Singapore 
c Memory Aging and Cognition Center, National University Health System, Singapore. National University Health System Tower Block, 1E Kent Ridge Road Level 11 119228, Singapore 
d 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 
e Dementia Research Centre, Lee Kong Chian School of Medicine, Singapore. 11 Mandalay Rd 308232, Singapore 

Corresponding author.

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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.

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Keywords : Cognitive impairment, Vascular dementia, Neuroimaging, Point-based scoring, Southeast Asian population

Abbreviations : AD, ARWMHC, BMI, CeVD, CIND, CISS, EDIS, ICS, ML, MRI, MTA, NCI, NEURO-BMC, RF, ROC, VaD, WMH


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 Submitted to: The Journal of Prevention of Alzheimer's Disease.


© 2025  Pubblicato da Elsevier Masson SAS.
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Vol 12 - N° 4

Articolo 100069- aprile 2025 Ritorno al numero
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