P3‐085: Amnestic mild cognitive impairment in a memory clinic: Longitudinal course and predictors of progression
Bibliographic record
Abstract
We wished to examine the long-term natural history of Mild Cognitive Impairment (MCI) in a North American memory clinic, and evaluate differences between those who progress to dementia, and those who do not. Eighty-nine elderly subjects (mean age 74.8 years) referred to a teaching hospital memory clinic and meeting criteria for Amnestic MCI (with or without added cognitive deficits), were followed longitudinally at least 10 years since symptom onset. All received detailed clinical, neuropsychological and genetic assessments, including a detailed evaluation of time of onset of symptoms and MRI volumetrics (in half the cohort). At end of a 10 year follow-up period, 60 subjects had deteriorated to dementia, and 29 had not. Kaplan-Meier curve analysis indicated an s-shaped curve of progression, with a “decline to dementia” rate initially of about 15% of the subjects per year, tapering off after four years. Even up to 10 years after onset of symptoms, 25% of the cohort remained non-demented. Presence or absence of Apo-E4 genotype had minimal impact on progression to dementia over follow-up. Medial temporal lobe atrophy was present in significantly more progressors (56%) compared with non-progressors (7%). Progressors had significantly older age of symptom onset, along with worse delayed verbal memory performance (logical memory). Non-progressors did not have more co-morbidities than progressors. MCI in the memory clinic appears heterogeneous but is sometimes a stable diagnosis over the long term. There appears to be a clear clinical subgroup of ¼ of the subjects who will not deteriorate to dementia over long-term follow-up. Atrophy on MRI was specific, but not sensitive for progression to dementia.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".