Poster Presentation Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2025

Exploring dementia risk profiling and stratification tools for Aboriginal and Torres Strait Islander peoples using population data (120191)

Huong X. T. Nguyen 1 , Zoe Hyde 1 2 3 , Kate Smith 2 , Roslyn Malay 2 , Leon Flicker 3 , Kylie Radford 4 5 6 , Sarah Russell 7 8 , Rachel Quigley 7 8 , Betty Sagigi 7 9 , Edward Strivens 7 8 , Adrienne Withall 5 6 , Alison Timbery 4 , Terrence Donovan 4 , Brian Draper 10 , Kim Delbaere 11 12 , Louise Lavrencic 4 5 6 , Robert Cumming 13 , Jo-anne Hughson 1 , Rosie Watson 1 , Bridgette J. McNamara 14 15 , Dina LoGiudice 1
  1. Department of Medicine - Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
  2. Centre for Aboriginal Medical and Dental Health, Medical School, University of Western Australia, Perth, Australia
  3. Western Australian Centre for Health and Ageing, Medical School, University of Western Australia, Perth, Australia
  4. Neuroscience Research Australia, Sydney, Australia
  5. School of Psychology, University of New South Wales, Sydney, Australia
  6. Ageing Futures Institute, University of New South Wales, Sydney, Australia
  7. College of Medicine and Dentistry, James Cook University, Cairns, Australia
  8. Cairns and Hinterland Hospital and Health Service, Cairns, Australia
  9. Torres and Cape Hospital and Health Service, Thursday Island, Australia
  10. Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
  11. Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, Australia
  12. School of Health Sciences, University of New South Wales, Sydney, Australia
  13. School of Public Health, University of Sydney, Sydney, Australia
  14. Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, Australia
  15. Barwon South-West Public Health Unit, Barwon Health, Geelong, Australia

Aims: Risk evaluation tools can be useful in primary care to identify high-risk patients and provide a framework for managing chronic disease risk factors .  We aimed to develop risk stratification tools to facilitate timely detection of dementia in primary care. 

Methods: Candidate factors associated with dementia derived from a harmonised dataset (Kimberley Healthy Adults Project, Koori Growing Old Well Study and the Torres Strait Dementia Prevalence Study) were weighted based on their multivariable logistic regression coefficients and used to calculate a risk score.  A risk index was also constructed from the unweighted sum of risk factors present divided by the total number of factors assessed.  Receiver operating characteristic (ROC) curves were generated using Youden’s method to investigate the best cut-point to identify people at high risk of dementia.

Results: Ten candidate items (age, sex, education, stroke, head injury with LOC, epilepsy, diabetes, smoking, past alcohol use and depression) were weighted to construct a Cognitive Assets and Risk Evaluation (CARE) score (AUC of 0.86, 95% CI 0.82-0.90; sensitivity 83.78%, specificity 76.95% at the optimal cut point of 32).  As an index, these same factors had acceptable psychometric properties (AUC 0.80, 95% CI 0.75-0.85) and discriminatory powers were enhanced with the addition of other indicators and a four-item rapid screen based on the Kimberley Indigenous Cognitive Assessment. 

 Conclusions: We present exploratory work to support the development of dementia risk stratification tools that may be useful in primary care to identify Aboriginal and Torres Strait Islander patients for further dementia assessment.