A prediction model for mild cognitive impairment risk among the elderly
MA Zongkang1, LIU Xinglang1, LI Huihui1, HE Guowei1, YAN Ping1, ZHANG Chuanrong2, MA Xuan1, CHE Yajie1, YU Shan1, CHEN Fenghui1
1. School of Nursing, Xinjiang Medical University, Urumqi, Xinjiang 830017, China; 2. Yining County Yuqunweng Hui Ethnic Township Health Center, Yining, Xinjiang 835108, China
Abstract:Objective To develop a prediction model for mild cognitive impairment (MCI) risk among the elderly, so as to provide a tool for MCI early screening. Methods From July 2022 to September 2024, a multi-stage stratified random cluster sampling method was used to recruit permanent residents aged ≥65 years from the Xinjiang Uygur Autonomous Region as study participants. Data on sociodemographic characteristics, nutritional status, body composition indices, bone mineral density, and handgrip strength were collected through questionnaires and physical examinations. Sarcopenia was defined based on appendicular skeletal muscle index and handgrip strength. MCI was assessed using the Mini-Mental State Examination, with adjustments for educational level. Participants were randomly divided into a training set and a validation set in a 7∶3 ratio. LASSO regression and multivariable logistic regression models were employed to screen for predictors and construct an MCI risk prediction model. The predictive performance of the model was evaluated using receiver operating characteristic (ROC) curve and decision curve analysis (DCA). Results A total of 1 641 participants were surveyed, including 755 males (46.01%) and 886 females (53.99%). The majority of participants were aged 65-<75 years, comprising 1 154 individuals (70.32%). MCI was detected in 517 participants, corresponding to a detection rate of 31.51%. Resultsfrom LASSO regression and multivariate logistic regression analysis showed that residence (rural, OR = 2.323, 95% CI: 1.682-3.210), age (75-<85 years, OR = 1.405, 95% CI: 1.019-1.937; ≥85 years, OR = 3.655, 95% CI: 1.696-7.875), educational level (primary school, OR = 0.341, 95% CI: 0.247-0.472; junior high school, OR = 0.255, 95% CI: 0.160-0.408; high school, OR = 0.286, 95% CI: 0.154-0.531; bachelor's degree or above, OR = 0.120, 95% CI: 0.041-0.351), history of alcohol consumption (yes, OR = 3.216, 95% CI: 2.164-4.779), risk of malnutrition (yes, OR = 1.464, 95% CI: 1.064-2.014), sarcopenia (yes, OR = 3.197, 95% CI: 2.332-4.385), and waist-to-hip ratio (abnormal, OR = 1.540, 95% CI: 1.159-2.048) were identified as predictive factors for MCI among the elderly. In the training set, the area under the ROC curve, sensitivity, and specificity were 0.788, 0.719, and 0.712, respectively. In the validation set, the corresponding values were 0.784, 0.913, and 0.542, respectively. DCA demonstrated that the model provided a higher clinical net benefit for predicting MCI risk when the risk threshold probability ranged from 0.124 to 0.764. Conclusion The prediction model developed in this study demonstrates good discriminative ability and clinical utility, indicating its substantial value for predicting the MCI risk among the elderly.
马宗康, 刘星郎, 李惠惠, 何国威, 颜萍, 张传荣, 马萱, 车雅洁, 于珊, 陈凤辉. 老年人轻度认知功能障碍风险预测模型研究[J]. 预防医学, 2026, 38(2): 124-129.
MA Zongkang, LIU Xinglang, LI Huihui, HE Guowei, YAN Ping, ZHANG Chuanrong, MA Xuan, CHE Yajie, YU Shan, CHEN Fenghui. A prediction model for mild cognitive impairment risk among the elderly. Preventive Medicine, 2026, 38(2): 124-129.
[1] 冯钰惠,李珊珊,陶剑文,等.老年人认知功能障碍调查及其影响因素研究[J].中国全科医学,2024,27(26):3297-3303. [2] PÉREZ PALMER N,TREJO ORTEGA B,JOSHI P.Cognitive impairment in older adults:epidemiology,diagnosis,and treatment[J].Psychiatr Clin North Am,2022,45(4):639-661. [3] CHEN Y R,QIAN X L,ZHANG Y Y,et al.Prediction models for conversion from mild cognitive impairment to Alzheimer's disease:a systematic review and meta-analysis[J/OL].Front Aging Neurosci,2022,14[2026-01-26].https://doi.org/10.3389/fnagi.2022.840386. [4] 明淑萍,陈贵勤,邵卫.老年认知功能障碍慢病管理指南[J].中西医结合研究,2025,17(4):242-254. [5] 麻红梅,李月美,李晓芳,等.亚高原地区老年住院患者轻度认知障碍危险因素分析及预测模型构建[J].中华老年医学杂志,2022,41(1):80-85. [6] SPITZER R L,KROENKE K,WILLIAMS J B W,et al.A brief measure for assessing generalized anxiety disorder:the GAD-7[J].Arch Intern Med,2006,166(10):1092-1097. [7] SHEIKH J I,YESAVAGE J A.A knowledge assessment test for geriatric psychiatry[J].Hosp Community Psychiatry,1985,36(11):1160-1166. [8] RUBENSTEIN L Z,HARKER J O,SALVÀA,et al.Screening for undernutrition in geriatric practice:developing the short-form mini-nutritional assessment(MNA-SF)[J].J Gerontol A Biol Sci Med Sci,2001,56(6):366-372. [9] 中华医学会老年医学分会,国家老年疾病临床医学研究中心(湘雅医院).中国肌肉减少症诊疗指南(2024版)[J].中华医学杂志,2025,105(3):181-203. [10] 中国健康促进基金会基层医疗机构骨质疏松症诊断与治疗专家共识委员会.基层医疗机构骨质疏松症诊断和治疗专家共识(2021)[J].中国骨质疏松杂志,2021,27(7):937-944. [11] World Health Organization.Waist circumference and waist-hip ratio:report of a WHO expert consultation[EB/OL].[2026-01-26].https://www.WHO.int/publications/i/item/9789241501491. [12] FOLSTEIN M F,FOLSTEIN S E,MCHUGH P R.“Mini-mental state”.A practical method for grading the cognitive state of patients for the clinician[J].J Psychiatr Res,1975,12(3):189-198. [13] 中华医学会神经病学分会痴呆与认知障碍学组.轻度认知损害的神经心理评估专家共识(2025版)[J].中华医学杂志,2025,105(3):204-218. [14] 禹延雪,白茹玉,于文龙,等.≥60岁人群认知功能障碍发生现状及影响因素研究[J].中国全科医学,2023,26(21):2581-2588. [15] 范转转,王军永,谭萍芬.中国65岁及以上老年人认知功能的城乡差异及其影响因素分解[J].卫生软科学,2022,36(12):30-35,45. [16] 张媛,史凌云,吴瑞凯,等.老年病科住院患者轻度认知功能障碍的影响因素分析[J].预防医学,2024,36(4):299-303. [17] 李斌,李永超,宋燕,等.吸烟和轻中度饮酒与社区老年男性认知功能相关性研究[J].中国神经精神疾病杂志,2024,50(4):221-226. [18] 杨红艳,吴茜.轻度认知功能障碍病人营养状态及营养干预研究进展[J].护理研究,2020,34(20):3652-3655. [19] HU Y S,PENG W J,REN R J,et al.Sarcopenia and mild cognitive impairment among elderly adults:the first longitudinal evidence from CHARLS[J].J Cachexia Sarcopenia Muscle,2022,13(6):2944-2952. [20] 冯钰惠,乐璐潇,张德应,等.不同肥胖指标与社区老年人认知功能关系研究[J].老年医学与保健,2021,27(1):161-163,176.