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Psychiatry"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Dementia poses a growing global public health burden, particularly in low\u2010 and middle\u2010income countries where cognitive screening coverage remains limited. Current risk estimation tools often depend on cognitive testing or biomarkers, restricting their applicability in community and primary care settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To establish and validate a data\u2010driven analytical framework for developing a cognitive\u2010testing\u2010free dementia risk estimation tool (Cog\u2010Free) using routinely collected health examination data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>For this prospective cohort study, we developed Cog\u2010Free, an internet\u2010based dementia risk estimation tool, using 38 Least Absolute Shrinkage and Selection Operator\u2010selected risk\u2010associated variables and the optimal machine\u2010learning algorithm (logistic regression). The\u00a0optimal algorithm was internally validated with bootstrap resampling and externally tested in the Chinese Longitudinal Healthy Longevity Survey cohort. The tool was trained and internally validated in 2962 dementia\u2010free adults aged \u2265\u00a065\u00a0years (2018\u20132024), and its performance was compared with three established cognitive\u2010testing\u2010free tools.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Cog\u2010Free achieved the highest area under the receiver operating characteristics curve in the internal validation set (0.86 [95% confidence interval (CI) 0.82\u20130.89]) with an accuracy of 0.81 (95% CI 0.78\u20130.83), sensitivity 0.78 (95% CI 0.68\u20130.85) and specificity 0.81 (95% CI 0.78\u20130.84), significantly outperforming three existing tools (DeLong's test,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Several previously under\u2010recognized risk\u2010associated variables for dementia were identified, such as right\u2010hand grip strength, cognitive activity, having worse memory than peers, nighttime awakenings and income satisfaction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Cog\u2010Free provides a data\u2010driven, cognitive\u2010testing\u2010free and easily accessible approach for early dementia risk screening using routine health data. Its performance and web\u2010based design suggest potential utility as a pre\u2010screening and risk stratification tool within community health systems, including settings with limited access to cognitive testing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/gps3.70028","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T09:04:51Z","timestamp":1780304691000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and validation of a Cog\u2010Free risk predicting tool for dementia in a community setting"],"prefix":"10.1002","volume":"39","author":[{"given":"Jiwen","family":"Che","sequence":"first","affiliation":[{"name":"Geriatric Hospital Affiliated to Wuhan University of Science and Technology  Wuhan Hubei China"},{"name":"Hubei Provincial Clinical Research Center for Alzheimer\u2019s Disease Tian You Hospital School of Medicine Wuhan University of Science and 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