Dataset Information

Consensus Approaches to Identify Incident Dementia in Cohort Studies: Systematic Review and Approach in the Successful Aging after Elective Surgery Study.

ABSTRACT: OBJECTIVES:To survey the current methods used to ascertain dementia and mild cognitive impairment (MCI) in longitudinal cohort studies, to categorize differences in approaches and to identify key components of expert panel methodology in current use. METHODS:We searched PubMed for the past 10 years, from March 6, 2007 to March 6, 2017 using a combination of controlled vocabulary and keyword terms to identify expert panel consensus methods used to diagnose MCI or dementia in large cohort studies written in English. From these results, we identified a framework for reporting standards and describe as an exemplar the clinical consensus procedure used in an ongoing study of elective surgery patients (the Successful Aging after Elective Surgery study). RESULTS:Thirty-one articles representing unique cohorts were included. Among published methods, membership of experts panel varied significantly. There was more similarity in what types of information was use to ascertain disease status. However, information describing the diagnostic decision process and resolution of disagreements was often lacking. CONCLUSIONS:Methods used for expert panel diagnosis of MCI and dementia in large cohort studies are widely variable, and there is a need for more standardized reporting of these approaches. By describing the procedure in which our expert panel achieved consensus diagnoses, we hope to encourage the development and publication of well-founded and reproducible methods for diagnosis of MCI and dementia in longitudinal studies.

SUBMITTER: Kimchi EY

PROVIDER: S-EPMC5701828 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature

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Consensus Approaches to Identify Incident Dementia in Cohort Studies: Systematic Review and Approach in the Successful Aging after Elective Surgery Study.

Kimchi Eyal Y EY Hshieh Tammy T TT Guo Ray R Wong Bonnie B O'Connor Margaret M Marcantonio Edward R ER Metzger Eran D ED Strauss Jason J Arnold Steven E SE Inouye Sharon K SK Fong Tamara G TG

Journal of the American Medical Directors Association 20170918 12

<h4>Objectives</h4>To survey the current methods used to ascertain dementia and mild cognitive impairment (MCI) in longitudinal cohort studies, to categorize differences in approaches and to identify key components of expert panel methodology in current use.<h4>Methods</h4>We searched PubMed for the past 10 years, from March 6, 2007 to March 6, 2017 using a combination of controlled vocabulary and keyword terms to identify expert panel consensus methods used to diagnose MCI or dementia in large ...[more]

PMID: 28927945

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Project description:ObjectiveThis study aimed to evaluate the value of odors in the olfactory identification (OI) test and other known risk factors for predicting incident dementia in the prospective Shanghai Aging Study.MethodsAt baseline, OI was assessed using the Sniffin' Sticks Screening Test 12, which contains 12 different odors. Cognition assessment and consensus diagnosis were conducted at both baseline and follow-up to identify incident dementia. Four different multivariable logistic regression (MLR) models were used for predicting incident dementia. In the no-odor model, only demographics, lifestyle, and medical history variables were included. In the single-odor model, we further added one single odor to the first model. In the full model, all 12 odors were included. In the stepwise model, the variables were selected using a bidirectional stepwise selection method. The predictive abilities of these models were evaluated by the area under the receiver operating characteristic curve (AUC). The permutation importance method was used to evaluate the relative importance of different odors and other known risk factors.ResultsSeventy-five (8%) incident dementia cases were diagnosed during 4.9 years of follow-up among 947 participants. The full and the stepwise MLR model (AUC = 0.916 and 0.914, respectively) have better predictive abilities compared with those of the no- or single-odor models. The five most important variables are Mini-Mental State Examination (MMSE) score, age, peppermint detection, coronary artery disease, and height in the full model, and MMSE, age, peppermint detection, stroke, and education in the stepwise model. The combination of only the top five variables in the stepwise model (AUC = 0.901 and sensitivity = 0.880) has as a good a predictive ability as other models.ConclusionThe ability to smell peppermint might be one of the useful indicators for predicting dementia. Combining peppermint detection with MMSE, age, education, and history of stroke may have sensitive and robust predictive value for dementia in older adults.

Dataset Information

Consensus Approaches to Identify Incident Dementia in Cohort Studies: Systematic Review and Approach in the Successful Aging after Elective Surgery Study.

Publications

Consensus Approaches to Identify Incident Dementia in Cohort Studies: Systematic Review and Approach in the Successful Aging after Elective Surgery Study.

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