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Community-based Model for Dementia Risk Screening: The Beijing Aging Brain Rejuvenation Initiative (BABRI) Brain Health System

  • Yiru Yang
    Affiliations
    State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China

    Beijing Aging Brain Rejuvenation Initiative (BABRI) Centre, Beijing Normal University, Beijing, China
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  • Chenlong Lv
    Affiliations
    Teaching and Research Section, Graduate School, Academy of Military Sciences, Beijing, China
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  • He Li
    Affiliations
    Beijing Aging Brain Rejuvenation Initiative (BABRI) Centre, Beijing Normal University, Beijing, China

    Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
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  • Kewei Chen
    Affiliations
    Banner Alzheimer's Institute, Phoenix, AZ, USA
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  • Xin Li
    Affiliations
    State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China

    Beijing Aging Brain Rejuvenation Initiative (BABRI) Centre, Beijing Normal University, Beijing, China
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  • Yaojing Chen
    Affiliations
    State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China

    Beijing Aging Brain Rejuvenation Initiative (BABRI) Centre, Beijing Normal University, Beijing, China
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  • Junying Zhang
    Affiliations
    Beijing Aging Brain Rejuvenation Initiative (BABRI) Centre, Beijing Normal University, Beijing, China

    Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
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  • Dongfeng Wei
    Affiliations
    Beijing Aging Brain Rejuvenation Initiative (BABRI) Centre, Beijing Normal University, Beijing, China

    Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
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  • Peng Lu
    Affiliations
    State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China

    Beijing Aging Brain Rejuvenation Initiative (BABRI) Centre, Beijing Normal University, Beijing, China
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  • Jun Wang
    Affiliations
    State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China

    Beijing Aging Brain Rejuvenation Initiative (BABRI) Centre, Beijing Normal University, Beijing, China
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  • Zhanjun Zhang
    Correspondence
    Address correspondence to Zhanjun Zhang, MD, State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China.
    Affiliations
    State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China

    Beijing Aging Brain Rejuvenation Initiative (BABRI) Centre, Beijing Normal University, Beijing, China
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Published:January 22, 2021DOI:https://doi.org/10.1016/j.jamda.2020.12.024

      Abstract

      Objectives

      To address the condition that community-based geriatric services for the assessment and promotion of older adults’ cognitive ability systemically aimed at delaying or preventing dementia is lacking in China.

      Design

      A community-based model including cognitive assessment and training, geriatric health guidance and long-term support was designed based on a prospective cohort study.

      Setting and Participants

      Participants (N = 5593) were all from an ongoing cohort study, the Beijing Aging Brain Rejuvenation Initiative (BABRI) study.

      Methods

      We conducted receiver operating characteristic, stepwise logistic regression and branch-and-bound algorithm analyses to select the most effective tests from the BABRI neuropsychological test battery. Canonical discriminant analysis was conducted to extract the first canonical variable as a composite index of the tests. In addition, we developed comprehensive surveys and computerized cognitive trainings targeting every cognitive domain.

      Results

      The BABRI brain health system (BABRI-BHS) was designed to include SCREEN, ASSESS, and DIAGNOSE sessions. When distinguishing cognitively impaired older adults from cognitively healthy older adults, the canonical variable extracted from tests in the SCREEN session achieved an area under the curve (AUC) of 0.730 [95% confidence interval (95% CI) 0.671–0.789], with a sensitivity of 0.630 and a specificity of 0.780; in the ASSESS session, the AUC was 0.906 (95% CI 0.894–0.917), the sensitivity was 0.809, and the specificity was 0.854. A stepwise screening pathway is recommended when using the BABRI-BHS in communities to divide older adults into subtypes and to provide targeted interventions and long-term geriatric health guidance.

      Conclusions and Implications

      The BABRI-BHS is an effective and efficient geriatric health care solution that is suitable for community-based dementia risk screening, providing stepwise cognitive assessments and helping older adults acquire tailored interventions and guidance conveniently.

      Keywords

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