Cognitive and physical markers of prodromal dementia: A 12-year-long population study

Alzheimers Dement. 2020 Jan;16(1):153-161. doi: 10.1002/alz.12002.


Introduction: The aim is to test whether adding a simple physical test such as walking speed (WS) to the neuropsychological assessment increases the predictive ability to detect dementia.

Methods: The 2546 dementia-free people from the SNAC-K study were grouped into four profiles: (1) healthy profile; (2) isolated cognitive impairment, no dementia (CIND, scoring 1.5 standard deviation below age-specific means on ≥1 cognitive domains); (3) isolated slow WS (<0.8 m/s); (4) CIND+ slow WS. The hazard of dementia (Cox regression), the positive and negative predictive values (PPV, NPV), and the area under the curve (AUC) were estimated.

Results: Participants with CIND +slow WS demonstrated the highest hazard of dementia (3.4; 95% confidence interval [CI]: 2.5-4.8). The AUC increased from 0.69 for isolated CIND to 0.83 for CIND+ slow WS. Such an increase was due to the improvement of the PPV, the NPV remaining optimal.

Discussion: Adding WS to the cognitive assessment dramatically increases the diagnostic accuracy of prodromal dementia.

Keywords: clinical markers; cognitive impairment; dementia; population-based study; walking speed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cognition Disorders / diagnosis*
  • Dementia* / diagnosis
  • Dementia* / epidemiology
  • Female
  • Healthy Volunteers
  • Humans
  • Longitudinal Studies
  • Male
  • Neuropsychological Tests
  • Prodromal Symptoms*
  • Sweden
  • Walking / physiology*