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Vroege predictoren van dementie, de constructie van beslisbomen

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Tijdschrift Gerontologie en Geriatrie

samenvatting

In order to identify persons who are at risk for dementia in an early phase, two classification trees were developed. Data were used from the Longitudinal Aging Study Amsterdam (LASA). The prevalence of dementia in the whole sample was 4.0%. In the first tree age seemed to be the strongest predictor, with an increased risk for persons older than 75. In this group the positive predictive value reached a maximum of 33.3% when the persons had memory complaints and a score on the Mini Mental State Examination (MMSE) < 24. In a second classification tree, age was excluded as a predictor because of high association with the other potential predictors. In this tree functional limitations seemed the strongest predictor. In the group of persons with at least one functional limitations, the positive predictive value reached a maximum of 28,8% when the persons had memory complaints and a score < 24 on the MMSE. In persons without memory complaints, persons with cardiovascular diseases or diabetes were at increased risk of dementia. Further research is necessary before these classification trees can be implemented in general health care.

Samenvatting

Om mensen met dementie in de eerste lijn in een vroeg stadium van de ziekte te kunnen identificeren zijn met, behulp van gegevens uit de Longitudinal Aging Study Amsterdam (LASA), twee beslismodellen ontwikkeld. Hierbij is gebruikgemaakt van een combinatie van simpele, goed herkenbare predictoren. De sterkste predictor van dementie bleek leeftijd, met een sterk verhoogd risico voor mensen boven de 75 jaar. De voorspellende waarde van dementie in deze groep werd ruim twee keer groter (10,2%) dan die was in de hele steekproef (4,0%). Als mensen bovendien geheugenklachten hadden en een Mini Mental State Examination (MMSE) < 24 bleek de voorspellende waarde verder toe te nemen tot respectievelijk 15,4% en 33,3%. In het tweede beslismodel, waar leeftijd buiten beschouwing is gelaten, bleken functionele beperkingen, geheugenklachten en een MMSE < 24 te leiden tot een maximale voorspellende waarde van 28,8%. Bij mensen met functionele beperkingen, maar zonder geheugenklachten bleek het hebben van een cardiovasculaire ziekte of diabetes het risico op dementie te vergroten. De beslismodellen zullen worden getoetst in een andere steekproef voordat ze worden geïmplementeerd in de eerste lijn.

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Authors and Affiliations

  1. www.bsl.nl/shop/tijdschrift-voor-gerontologie-en-geriatrie-0167-9228.html

    H. C. Comijs

Authors
  1. H. C. Comijs
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  2. M. G. Dik
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  3. F. Rijmen
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  4. C. Jonker
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  5. T. N. van den Kommer
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  6. D. J. H. Deeg
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Corresponding author

Correspondence to H. C. Comijs.

Additional information

senior onderzoeker, LASA, VU Medisch Centrum en GGZ Buitenamstel, Amsterdam

post doc onderzoeker, LASA, VU Medisch Centrum, Amsterdam

statistisch consulent, EMGO instituut, VU Medisch Centrum, Amsterdam

senior onderzoeker, VU Medisch Centrum, Amsterdam

junior onderzoeker, LASA, VU Medisch Centrum, Amsterdam

project manager LASA, VU Medisch Centrum, Amsterdam

Correspondentie: Mw. dr. Hannie C. ComijsEMGO institute / LASA VU University Medical Center Van der Boechorststraat 7 1081 BT Amsterdam tel: 020-4446770; Fax: 020-4446775

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Comijs, H.C., Dik, M.G., Rijmen, F. et al. Vroege predictoren van dementie, de constructie van beslisbomen. GEEG 37, 296–303 (2006). https://doi.org/10.1007/BF03074812

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