[P‐216]: The role of residential setting in determining the risk of cognitive impairment and dementia
Bibliographic record
Abstract
To date, randomised clinical trials (RCTs) on primary prevention of dementia have enriched their study samples with biological risk factors (age, family history of dementia, Apolipoprotein E genotype) to achieve higher projected rates of progression to dementia. There has been very limited attention on environmental risk factors including residential setting. To determine if residential setting (community or institution) can be used as a sample-enriching factor associated with increased rates of progression to dementia. This study compared the rates of progression from cognitively normal to a) Cognitive-Impairment-Not-Dementia (CIND) and b) dementia in subjects living in institutions (IN) or in the community (CO) within the Canadian Study of Health and Aging (CSHA). The CSHA is a population-based cohort study of subjects aged 65 or older. In the present study subjects all were clinically evaluated at entry and at 5 years. The diagnoses of normal, CIND and dementia were made according to DSM-III-R criteria. Rates of progression were computed for IN and CO subjects and then stratified by age group (<75 or <>75), sex, education ( grade 12) and initial Modified Mini-Mental Status Examination (3MS) (<90 or <>90). Chi-square tests were performed with significant findings based on p<0.05. There were 322 subjects (63 IN, 259 CO) at baseline who were diagnosed as cognitively normal. Of these 66% remained normal after 5 years, 23% progressed to CIND and 11% to dementia. Compared to CO subjects, IN subjects had significantly higher rates of progression to CIND (27 vs. 22%) and to dementia (18 vs. 9%). For age and 3MS level, this effect was specific to age <>75 years and 3MS<90. Elderly individuals living in institutions are identified to be at an increased risk of developing both cognitive impairment and dementia. This environmental factor may further assist the enrichment of RCT study samples and should raise awareness of the potential role of non-biological factors within prevention study designs.
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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 | 0.014 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.020 | 0.002 |
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".