Study protocol for development and validation of a single tool to assess risks of stroke, diabetes mellitus, myocardial infarction and dementia: DemNCD-Risk
Introduction Current efforts to reduce dementia focus on prevention and risk reduction by targeting modifiable risk factors. As dementia and cardiometabolic non-communicable diseases (NCDs) share risk factors, a single risk-estimating tool for dementia and multiple NCDs could be cost-effective and f...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2023-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/9/e076860.full |
| _version_ | 1797669052569616384 |
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| author | Miia Kivipelto Ruth Peters Kaarin J Anstey Louisa Jorm Kim M Kiely Nicola T Lautenschlager Craig S Anderson Jonathan E Shaw Rachel A Whitmer Fiona Matthews Md Hamidul Huque Scherazad Kootar |
| author_facet | Miia Kivipelto Ruth Peters Kaarin J Anstey Louisa Jorm Kim M Kiely Nicola T Lautenschlager Craig S Anderson Jonathan E Shaw Rachel A Whitmer Fiona Matthews Md Hamidul Huque Scherazad Kootar |
| author_sort | Miia Kivipelto |
| collection | DOAJ |
| description | Introduction Current efforts to reduce dementia focus on prevention and risk reduction by targeting modifiable risk factors. As dementia and cardiometabolic non-communicable diseases (NCDs) share risk factors, a single risk-estimating tool for dementia and multiple NCDs could be cost-effective and facilitate concurrent assessments as compared with a conventional single approach. The aim of this study is to develop and validate a new risk tool that estimates an individual’s risk of developing dementia and other NCDs including diabetes mellitus, stroke and myocardial infarction. Once validated, it could be used by the public and general practitioners.Methods and analysis Ten high-quality cohort studies from multiple countries were identified, which met eligibility criteria, including large representative samples, long-term follow-up, data on clinical diagnoses of dementia and NCDs, recognised modifiable risk factors for the four NCDs and mortality data. Pooled harmonised data from the cohorts will be used, with 65% randomly allocated for development of the predictive model and 35% for testing. Predictors include sociodemographic characteristics, general health risk factors and lifestyle/behavioural risk factors. A subdistribution hazard model will assess the risk factors’ contribution to the outcome, adjusting for competing mortality risks. Point-based scoring algorithms will be built using predictor weights, internally validated and the discriminative ability and calibration of the model will be assessed for the outcomes. Sensitivity analyses will include recalculating risk scores using logistic regression.Ethics and dissemination Ethics approval is provided by the University of New South Wales Human Research Ethics Committee (UNSW HREC; protocol numbers HC200515, HC3413). All data are deidentified and securely stored on servers at Neuroscience Research Australia. Study findings will be presented at conferences and published in peer-reviewed journals. The tool will be accessible as a public health resource. Knowledge translation and implementation work will explore strategies to apply the tool in clinical practice. |
| first_indexed | 2024-03-11T20:38:34Z |
| format | Article |
| id | doaj.art-ab347e2eb8634c548fb80a26edbe0e04 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-11T20:38:34Z |
| publishDate | 2023-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-ab347e2eb8634c548fb80a26edbe0e042023-10-02T04:15:07ZengBMJ Publishing GroupBMJ Open2044-60552023-09-0113910.1136/bmjopen-2023-076860Study protocol for development and validation of a single tool to assess risks of stroke, diabetes mellitus, myocardial infarction and dementia: DemNCD-RiskMiia Kivipelto0Ruth Peters1Kaarin J Anstey2Louisa Jorm3Kim M Kiely4Nicola T Lautenschlager5Craig S Anderson6Jonathan E Shaw7Rachel A Whitmer8Fiona Matthews9Md Hamidul Huque10Scherazad Kootar11Division of Geriatric Epidemiology, Karolinska Institutet, Stockholm, SwedenUniversity of New South Wales, Sydney, New South Wales, AustraliaNeuroscience Research Australia, Randwick, New South Wales, AustraliaCentre for Big Data Research in Health, University of New South Wales, Randwick, New South Wales, AustraliaNeuroscience Research Australia, Randwick, New South Wales, AustraliaOlder Adult Mental Health Program, Royal Melbourne Hospital Mental Health Service, Parkville, Victoria, AustraliaThe George Institute for Global Health, George Institute for Global Health, Newtown, New South Wales, AustraliaClinical and Population Health, Baker Heart and Diabetes Institute, Melbourne, Victoria, AustraliaUniversity of California Davis, Davis, California, USAPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UKNeuroscience Research Australia, Randwick, New South Wales, AustraliaNeuroscience Research Australia, Randwick, New South Wales, AustraliaIntroduction Current efforts to reduce dementia focus on prevention and risk reduction by targeting modifiable risk factors. As dementia and cardiometabolic non-communicable diseases (NCDs) share risk factors, a single risk-estimating tool for dementia and multiple NCDs could be cost-effective and facilitate concurrent assessments as compared with a conventional single approach. The aim of this study is to develop and validate a new risk tool that estimates an individual’s risk of developing dementia and other NCDs including diabetes mellitus, stroke and myocardial infarction. Once validated, it could be used by the public and general practitioners.Methods and analysis Ten high-quality cohort studies from multiple countries were identified, which met eligibility criteria, including large representative samples, long-term follow-up, data on clinical diagnoses of dementia and NCDs, recognised modifiable risk factors for the four NCDs and mortality data. Pooled harmonised data from the cohorts will be used, with 65% randomly allocated for development of the predictive model and 35% for testing. Predictors include sociodemographic characteristics, general health risk factors and lifestyle/behavioural risk factors. A subdistribution hazard model will assess the risk factors’ contribution to the outcome, adjusting for competing mortality risks. Point-based scoring algorithms will be built using predictor weights, internally validated and the discriminative ability and calibration of the model will be assessed for the outcomes. Sensitivity analyses will include recalculating risk scores using logistic regression.Ethics and dissemination Ethics approval is provided by the University of New South Wales Human Research Ethics Committee (UNSW HREC; protocol numbers HC200515, HC3413). All data are deidentified and securely stored on servers at Neuroscience Research Australia. Study findings will be presented at conferences and published in peer-reviewed journals. The tool will be accessible as a public health resource. Knowledge translation and implementation work will explore strategies to apply the tool in clinical practice.https://bmjopen.bmj.com/content/13/9/e076860.full |
| spellingShingle | Miia Kivipelto Ruth Peters Kaarin J Anstey Louisa Jorm Kim M Kiely Nicola T Lautenschlager Craig S Anderson Jonathan E Shaw Rachel A Whitmer Fiona Matthews Md Hamidul Huque Scherazad Kootar Study protocol for development and validation of a single tool to assess risks of stroke, diabetes mellitus, myocardial infarction and dementia: DemNCD-Risk BMJ Open |
| title | Study protocol for development and validation of a single tool to assess risks of stroke, diabetes mellitus, myocardial infarction and dementia: DemNCD-Risk |
| title_full | Study protocol for development and validation of a single tool to assess risks of stroke, diabetes mellitus, myocardial infarction and dementia: DemNCD-Risk |
| title_fullStr | Study protocol for development and validation of a single tool to assess risks of stroke, diabetes mellitus, myocardial infarction and dementia: DemNCD-Risk |
| title_full_unstemmed | Study protocol for development and validation of a single tool to assess risks of stroke, diabetes mellitus, myocardial infarction and dementia: DemNCD-Risk |
| title_short | Study protocol for development and validation of a single tool to assess risks of stroke, diabetes mellitus, myocardial infarction and dementia: DemNCD-Risk |
| title_sort | study protocol for development and validation of a single tool to assess risks of stroke diabetes mellitus myocardial infarction and dementia demncd risk |
| url | https://bmjopen.bmj.com/content/13/9/e076860.full |
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