Survival in Dementia and Cognitive Impairment Not Dementia: 16 Year Follow Up from the ACCORD Study (P1.102)
Bibliographic record
Abstract
Objective: Examine survival and risk factor effects in a cohort of cognitive impairment not dementia (CIND) and dementia. Compare survival to general population in British Columbia (BC). Background: Estimates of survival are integral to the care of patients diagnosed with dementia. Few Canadian studies have long-term follow-up of well-described cohorts, analyzing survival with multiple risk factors. Design/Methods: We studied survival at a single ACCORD center site. 218 patients diagnosed with CIND or dementia followed from recruitment between 1997-1999. Vital status completed for all patients on censor date (June 20, 2015). Risk factors including age, sex, education, MMSE, CIRS, NPI, FRS, DAD, Hachinski, vascular risk factors, APOE4, and AchEI use evaluated in AD and Other Dementias (OD) subgroups using Kaplan-Meier and Cox regression. Survival compared to age-matched life expectancy in BC. Results: Overall 183 (84[percnt]) deaths observed over 16.6 years mean follow up. 16/39 (41[percnt]) CIND died; 136/144 (94[percnt]) AD died; 31/35 (89[percnt]) OD died (median survival for dementia groups: 7.1 years). Given the heterogeneity and small sample size of CIND, effects of risk factors were evaluated only in patients with dementia. Survival times did not vary between AD and OD (p=0.53). Shorter survival was associated with age, DAD scores <55[percnt] (HR 1.92, 95[percnt]CI 1.20-3.08) and CIRS scores >7 (HR 1.90, 95[percnt]CI 1.23-2.93); the latter two remained significant after adjustment. No significant effect was observed with other variables. Compared to BC population, decrease of life expectancy for dementia subjects aged 65-69 was 11.35 years and 1.82 years for ≥80. Conclusions: Survival with dementia is shorter than population life expectancies for each age strata, with greatest impact in younger patients. Cumulative medical illness and functional disabilities are the most significant predictors of survival and can guide prognosis. ACCORD funded by Canada’s Medical Research Council (now CIHR) and Pharmaceutical Manufacturers’ Association of Canada.
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".