[O1‐02‐02]: Loss of initiation and planning predicts progression from CIND to Alzheimer's disease
Bibliographic record
Abstract
Patients who are cognitively impaired not demented (CIND) are at risk for progression to dementia. The Disability Assessment of Dementia (DAD) scale is an informant-based instrument that examines an individual's ability to carry out basic (BADL) and instrumental activities of daily living (IADL). Patterns of BADL and IADL impairment may aid in the prediction of progression to Alzheimer's disease (AD) in CIND. To characterize the pattern of earliest functional decline in CIND subjects prior to their progression to dementia. CIND subjects (n=342) from A Canadian Cohort study of Cognitive Impairment and Related Dementias (ACCORD) were followed for 2 years. We examined the impairments measured in the DAD scale and compared the baseline scores and 2-year change scores of CIND subjects who remained stable, CIND subjects who progressed to AD, and primary AD patients. Analysis of covariance adjusted for age, sex, and education level was used to compare group means. At baseline, the BADL and IADL scores of stable CIND and CIND who progressed to AD were not different, whereas, as expected, those of primary AD subjects were significantly lower. However at 2-year follow up, the CIND subjects who progressed demonstrated an overall decline in their overall DAD scores. Significant decline in IADL was noted through their ability to handle finance and correspondence (p=0.013), telephone (p=0.002), leisure activities (p<0.001), and outings (p<0.001). When DAD scores were broken down by category of ability, significant decline was observed in the subjects’ initiation and planning, but not their performance ability as they progressed from CIND to AD. Declines in the ability to handle finances and plan outings are the earliest functional changes detected in the DAD that are associated with progression from CIND to AD. These declines reflect losses in initiation and planning that compromise IADL but not BADL. It is suggested that the IADL component of the DAD scale is a responsive instrument for assessing progression of CIND to AD.
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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 | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 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 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
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".