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Study protocol for development and validation of a single tool to assess risks of stroke, diabetes mellitus, myocardial infarction and dementia: DemNCD-Risk

Kootar, Scherazad; Huque, Md Hamidul; Kiely, Kim M.; Anderson, Craig S.; Jorm, Louisa; Kivipelto, Miia; Lautenschlager, Nicola T.; Matthews, Fiona; Shaw, Jonathan E.; Whitmer, Rachel A.; Peters, Ruth; Anstey, Kaarin J.

Authors

Scherazad Kootar

Md Hamidul Huque

Kim M. Kiely

Craig S. Anderson

Louisa Jorm

Miia Kivipelto

Nicola T. Lautenschlager

Jonathan E. Shaw

Rachel A. Whitmer

Ruth Peters

Kaarin J. Anstey



Abstract

Introduction Current efforts to reduce dementia focus on prevention and risk reduction by targeting modifiable risk factors. As dementia and cardiometabolic non-communicable diseases (NCDs) share risk factors, a single risk-estimating tool for dementia and multiple NCDs could be cost-effective and facilitate concurrent assessments as compared with a conventional single approach. The aim of this study is to develop and validate a new risk tool that estimates an individual's risk of developing dementia and other NCDs including diabetes mellitus, stroke and myocardial infarction. Once validated, it could be used by the public and general practitioners. Methods and analysis Ten high-quality cohort studies from multiple countries were identified, which met eligibility criteria, including large representative samples, long-term follow-up, data on clinical diagnoses of dementia and NCDs, recognised modifiable risk factors for the four NCDs and mortality data. Pooled harmonised data from the cohorts will be used, with 65% randomly allocated for development of the predictive model and 35% for testing. Predictors include sociodemographic characteristics, general health risk factors and lifestyle/behavioural risk factors. A subdistribution hazard model will assess the risk factors' contribution to the outcome, adjusting for competing mortality risks. Point-based scoring algorithms will be built using predictor weights, internally validated and the discriminative ability and calibration of the model will be assessed for the outcomes. Sensitivity analyses will include recalculating risk scores using logistic regression. Ethics and dissemination Ethics approval is provided by the University of New South Wales Human Research Ethics Committee (UNSW HREC; protocol numbers HC200515, HC3413). All data are deidentified and securely stored on servers at Neuroscience Research Australia. Study findings will be presented at conferences and published in peer-reviewed journals. The tool will be accessible as a public health resource. Knowledge translation and implementation work will explore strategies to apply the tool in clinical practice.

Citation

Kootar, S., Huque, M. H., Kiely, K. M., Anderson, C. S., Jorm, L., Kivipelto, M., …Anstey, K. J. (2023). Study protocol for development and validation of a single tool to assess risks of stroke, diabetes mellitus, myocardial infarction and dementia: DemNCD-Risk. BMJ open, 13(9), Article e076860. https://doi.org/10.1136/bmjopen-2023-076860

Journal Article Type Article
Acceptance Date Sep 5, 2023
Online Publication Date Sep 22, 2023
Publication Date Sep 22, 2023
Deposit Date Dec 10, 2023
Publicly Available Date Dec 11, 2023
Journal BMJ Open
Print ISSN 2044-6055
Electronic ISSN 2044-6055
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 13
Issue 9
Article Number e076860
DOI https://doi.org/10.1136/bmjopen-2023-076860
Public URL https://hull-repository.worktribe.com/output/4450756

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Publisher Licence URL
http://creativecommons.org/licenses/by/4.0

Copyright Statement
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/
This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.




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