Dementia Population Risk Tool (DemPoRT): study protocol for a predictive algorithm assessing dementia risk in the community

Stacey Fisher; Amy Hsu; Nassim Mojaverian; Monica Taljaard; Gregory Huyer; Douglas G Manuel; Peter Tanuseputro

doi:10.1136/bmjopen-2017-018018

Dementia Population Risk Tool (DemPoRT): study protocol for a predictive algorithm assessing dementia risk in the community

BMJ Open. 2017 Oct 24;7(10):e018018. doi: 10.1136/bmjopen-2017-018018.

Authors

Stacey Fisher^{1

2

3}, Amy Hsu^{1

2}, Nassim Mojaverian², Monica Taljaard^{1

3}, Gregory Huyer⁴, Douglas G Manuel^{1

2

3

5

6}, Peter Tanuseputro^{1

2

6

7

8}

Affiliations

¹ Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
² Institute for Clinical Evaluative Sciences, Ottawa, Ontario, Canada.
³ Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada.
⁴ Telfer School of Management, University of Ottawa, Ottawa, Ontario, Canada.
⁵ Statistics Canada, Ottawa, Ontario, Canada.
⁶ Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada.
⁷ Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
⁸ Bruyère Research Institute, Ottawa, Ontario, Canada.

Abstract

Introduction: The burden of disease from dementia is a growing global concern as incidence increases dramatically with age, and average life expectancy has been increasing around the world. Planning for an ageing population requires reliable projections of dementia prevalence; however, existing population projections are simple and have poor predictive accuracy. The Dementia Population Risk Tool (DemPoRT) will predict incidence of dementia in the population setting using multivariable modelling techniques and will be used to project dementia prevalence.

Methods and analysis: The derivation cohort will consist of elderly Ontario respondents of the Canadian Community Health Survey (CCHS) (2001, 2003, 2005 and 2007; 18 764 males and 25 288 females). Prespecified predictors include sociodemographic, general health, behavioural, functional and health condition variables. Incident dementia will be identified through individual linkage of survey respondents to population-level administrative healthcare databases (1797 and 3281 events, and 117 795 and 166 573 person-years of follow-up, for males and females, respectively, until 31 March 2014). Using time of first dementia capture as the primary outcome and death as a competing risk, sex-specific proportional hazards regression models will be estimated. The 2008/2009 CCHS survey will be used for validation (approximately 4600 males and 6300 females). Overall calibration and discrimination will be assessed as well as calibration within predefined subgroups of importance to clinicians and policy makers.

Ethics and dissemination: Research ethics approval has been granted by the Ottawa Health Science Network Research Ethics Board. DemPoRT results will be submitted for publication in peer-review journals and presented at scientific meetings. The algorithm will be assessable online for both population and individual uses.

Trial registration number: ClinicalTrials.gov NCT03155815, pre-results.

Keywords: dementia; health behavior; population projection; risk stratification.

Publication types

Validation Study

MeSH terms

Aged
Aged, 80 and over
Algorithms
Cohort Studies
Dementia / epidemiology*
Female
Forecasting / methods*
Humans
Incidence
Life Expectancy
Male
Middle Aged
Ontario / epidemiology
Population Surveillance
Proportional Hazards Models
Research Design*
Risk Assessment / methods*
Risk Factors
Sex Distribution
Smoking / epidemiology

Associated data

ClinicalTrials.gov/NCT03155815