The Vulnerability Index: A weighted measure of dementia and cognitive impairment risk

Michael J. Kleiman, James E. Galvin

Research output: Contribution to journalArticlepeer-review


Introduction: A brief, easily calculated and interpretable index to assess vulnerability to developing cognitive impairment is needed in clinical practice and research. To address this, we developed the Vulnerability Index (VI) with the goal of identifying individuals possessing a high risk for cognitive impairment. Methods: Twelve easily obtained sociodemographic, medical, and functional factors were used to develop the VI, with each selectively weighted based on factor analysis and predictive modeling. This cross-sectional study examined 387 subject-partner dyads. Results: The VI was found to accurately discriminate between cognitively normal controls and participants with cognitive impairment (area under the curve [AUC]: 0.844; 95% confidence interval [CI]: 0.776-0.913) and individuals scoring high on the VI (≥8) had worse health, functional, behavioral, cognitive, and quality of life ratings than those with lower scores. Discussion: The VI could be used in screening asymptomatic individuals for risk of cognitive impairment and guiding the development of primary and secondary prevention plans.

Original languageEnglish (US)
Article numbere12249
JournalAlzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
Issue number1
StatePublished - 2021
Externally publishedYes


  • Alzheimer's disease
  • cognitive impairment
  • dementia
  • functional assessments
  • health records
  • primary prevention
  • risk assessment
  • screening
  • sociodemographics

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health


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