P2‐196: Differences in dementia presentation among elderly Asians compared to non‐Asians
Bibliographic record
Abstract
Previous studies suggested that Asian patients with dementia presented at a more severe stage than non-Asians. Our study objective was to explore differences in dementia presentation among elderly Asians compared to non-Asians. We conducted a retrospective chart review of patient visits in 2000-2009 from 2 tertiary referral ambulatory clinics at a major academic health science centre. Data collection included baseline demographics, medical history, and mini-mental state examination (MMSE) scores. Alzheimer's disease (AD) was diagnosed by DSM-IV criteria and vascular dementia (VaD) by radiological finding of cerebrovascular disease and vascular risk factors plus cognitive syndrome. We compared continuous variables using two-tailed t-tests and discontinuous variables by Pearson chi-square. There were 927 patients (Asians 406, non-Asians 521) diagnosed with dementia with 58.9% females. Most patients were elderly, with 38.0% age 70-79, 31.1% age 80-89 and 3.8% age 90 and above. The Asian patients in this cohort were significantly older than non-Asians (P = 0.00). Vascular risk factors were prevalent in all patients at initial presentation (Asians 73.9%, non-Asians 77.7%, P = 0.17). The most common dementia diagnosis was AD (75.6%), followed by mixed AD/VaD (12.2%), other dementias (8.5%) and VaD (3.6%). There was no gender difference in distribution of dementia types (P = 0.14). Non-AD non-vascular dementias were significantly more prevalent in non-Asians (17.3%) than Asians (4.2%, P = 0.00). Asian dementia patients presented with lower MMSE 18.4 [5.9] (mean [SD]) than non-Asian dementia patients 22.2 [5.8] (P = 0.00) at initial clinic visit, and the difference narrowed by the final visit: Asians 17.7 [6.4], non-Asians 18.7 [7.1] (P = 0.07). In general, Asian patients had fewer clinic visits 3.2 [2.9] than non-Asians 4.2 [3.5] (P = 0.00). In our cohort, Asian patients with dementia presented at an older age, at a more severe stage (lower MMSE), and had fewer follow-up visits to the specialist clinics compared to non-Asians. Further studies are warranted to explore plausible biologic, psychological, social, cultural, economic, or educational determinants of such presentation differences.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".