P4‐005: Risk factors influencing survival in Alzheimer's disease: Analysis from a single center in the Canadian cohort study of cognitive impairment and related dementias (ACCORD)
Bibliographic record
Abstract
Previous studies have indicated that survival after the diagnosis of AD varies considerably with estimates from 3.3 to 9.3 years from disease onset. This variation is likely influenced by demographics as well as disease risk factors. In this study, we examined the effects of APOE, Cholinesterase Inhibitors (CHEI) use, vascular, and demographic risk factors on the overall survival of AD. There were 146 patients diagnosed with AD (NINCDS-ADRDA criteria) at the Vancouver site within the ACCORD cohort (inception 1997–1999).Vital status was complete for all 146 AD patients on censor date (Sept 30, 2006). Survival was calculated by subtracting the time of death from the time of diagnosis. Risk factors, including age at time of diagnosis, Sex, years of education, MMSE score, CIRS, Rosen & Hachinski scores, APOE genotype, Vascular risk factors (diabetes mellitus (DM), hypertension, dyslipidemia, and atherosclerosis), and CHEI use were evaluated using log-rank test and Cox regression. Seventy three (50%) patients died during a follow up of up to 10 years. The median survival for all patients with AD was 8.2 years. Patients with DM has shorter survival (median = 4.7) compared to those without DM (median = 9.5, HR 2.2, 95% CI 1.1–4.6). A score of 7 or above on the CIRS was also associated with shorter survival (HR 2.4, 95%CI 1.2–4.7). However, there was significant collinearity between presence of DM and CIRS. Male sex and lower MMSE at the time of diagnosis were also associated with shorter survival. No significant effect on survival was observed with other vascular risk factors, APOE genotype, or use of CHEI. Co-existing DM and increasing number of comorbid conditions shorten survival with AD, while other vascular risk factors (Hypertension, Dyslipidemia, and Atherosclerosis) or use of CHEI had no significant effect.
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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) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.002 | 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".