Social vulnerability predicts cognitive decline in a prospective cohort of older Canadians
Bibliographic record
Abstract
BACKGROUND: Although numerous social factors have been associated with cognition in older adults, these findings have been limited by the consideration of individual factors in isolation. We investigated whether social vulnerability, defined as an index comprising many social factors, is associated with cognitive decline. METHODS: In this secondary analysis of the Canadian Study of Health and Aging, 2468 community-dwellers aged 70 and older were followed up for 5 years. The social vulnerability index incorporated 40 social variables. Each response was scored as 0 if the "deficit" was absent and 1 if it was present; the 40 deficit scores were then summed. For some analyses, index scores were split into tertiles of high, intermediate, and low social vulnerability. Cognitive decline was defined as a >or=5-point decline in the Modified Mini-Mental State Examination (3MS). Associations of social vulnerability with 5-year cognitive decline (adjusting for age, sex, frailty, and baseline cognition) were analyzed by using logistic regression. RESULTS: Mean social vulnerability was 0.25 (standard deviation, 0.09) or 9.9 deficits of the list of 40. The median cognitive change of -1.0 (interquartile range, -6 to 2) points on the 3MS was noted at 5 years. About 743 individuals (30% of the sample) experienced a decline of >or=5 points on the 3MS. Each additional social deficit was associated with increased odds of cognitive decline (odds ratio, 1.03; 95% confidence interval, 1.00 to 1.06; P = .02). Compared with those with low social vulnerability, individuals with high social vulnerability had a 36% increased odds of experiencing cognitive decline (odds ratio, 1.36; 95% confidence interval, 1.06 to 1.74; P = .015). CONCLUSIONS: Increasing social vulnerability, defined by using a social vulnerability index incorporating many social factors, was associated with increased odds of cognitive decline during a period of 5 years in this study of older Canadians. Further study of social vulnerability in relation to cognition is warranted, with particular attention to potential interventions to alleviate its burden.
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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) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".