Mexican-American Dementia Nomogram: Development of a Dementia Risk Index for Mexican-American Older Adults

Objectives: To create a risk index (Mexican American Dementia Nomogram (MADeN)) that predicts dementia over a 10-year period for Mexican Americans aged 65 and older. Design: Retrospective cohort study with longitudinal analysis. Setting: Texas, New Mexico, Colorado, Arizona, and California. Participants: Hispanic Established Populations for the Epidemiologic Study of the Elderly (H-EPESE) participants (n = 1,739). Measurements: Dementia was defined as a decline of three or more points per year on the Mini-Mental State Examination and inability to perform one or more daily activities. Candidate risk factors included demographic characteristics, measures of social engagement, self-reported health conditions, ability to perform daily activities, and physical activity. Results: The MADeN comprised the following risk factors: age, sex, education, not having friends to count on, not attending community events, diabetes mellitus, feeling the blues, pain, impairment in instrumental activities of daily living, and unable to walk a half-mile. The area under the receiver operating characteristic curve was 0.74 (95% confidence interval (CI) = 0.70–0.78) and a score of 16 points or higher had a sensitivity of 0.65 (95% CI = 0.59–0.72) and specificity of 0.70 (95% CI = 0.67–0.73) in predicting dementia. Conclusion: The MADeN was able to predict dementia in a population of older Mexican-American adults with moderate accuracy. It has the potential to identify older Mexican-American adults who may benefit from interventions to reduce dementia risk and to educate this population about risk factors for dementia.