Abstract Body

AIMS: There is increasing interest in primary, secondary, and tertiary prevention approaches to address mild cognitive impairment (MCI) and Alzheimer’s disease and related dementias (ADRD). A significant challenge is measurement of resilience and vulnerability factors that can (a) distinguish between healthy brain aging and MCI/ADRD, and (b) serve as intervention targets. To address this challenge, we created the Resilience Index (RI), a quantifiable measure of brain health, and the Vulnerability Index (VI), a weighted measure of MCI/ADRD risk.

METHODS: We analyzed 241 participants completing a comprehensive clinical-cognitive evaluation. Six lifestyle factors (physical activity, cognitive activity, social engagement, dietary patterns, mindfulness, cognitive reserve) were combined to derive the RI. Twelve easily-obtained sociodemographic, medical, and functional factors were used to develop the VI.

RESULTS: The RI had a 9-fold odds ratio to discriminate individuals with and without cognitive impairment. Individuals with high RI scores (>143) had better cognitive, functional, and behavioral ratings than individuals with low RI scores. The VI had a 17-fold odd ratio to discriminate individuals with and without cognitive impairment. Individuals with high VI scores (≥8) had worse cognitive, functional, and behavioral ratings than those with low VI scores. Combining RI and VI scores differentiated between healthy controls and MCI/ADRD and provided insight into risk of transition/conversion.

CONCLUSIONS: The RI and VI are brief yet powerful indices of brain health and risk of MCI/ADRD. Combining resilience and vulnerability could provide a guide to develop personalized prevention plans to support brain health and identifying asymptomatic individuals for risk of MCI/ADRD.