[P3–436]: NATURAL HISTORY OF THE DECLINE IN INSTRUMENTAL ACTIVITIES OF DAILY LIVING PRIOR TO DEMENTIA IN PERSONS WITH MILD COGNITIVE IMPAIRMENT
Bibliographic record
Abstract
Very few studies have investigated how the decline in instrumental activities of daily living (iADL) unfolds in the years preceding a diagnosis of dementia and none, to our knowledge, did so by comparing participants with mild cognitive impairment (MCI) who converted to dementia, with those who did not progress to dementia. The goal of this study was to assess the pattern of decline in iADL for MCI progressors and to compare this pattern with the one found in MCI non-progressors. Participants were compared as a function of whether they later converted to Alzheimer's disease (progressors; n = 47), or remained cognitively stable during the 5-year follow-up (stable; n = 58). An 8-item functional autonomy questionnaire assessing iADL was given to the participants. iADL change was assessed prior to conversion year as a starting point. Following a principal components analysis, iADL items were clustered in 2 domains: housekeeping-related activities and complex iADL. A combination of polynomial regression analysis and mixed ANOVAs assessed 1) the trajectory of iADL decline for each domain and 2) the differences between MCI progressors and non-progressors. Cognitive decline scores were entered in a stepwise regression analysis to determine the significant predictors of iADL the following year. A quadratic function, i.e., many years of stable performance followed by an accelerated decline just prior to diagnosis, was observed for complex iADL. No significant model was found for the stable MCI. For housekeeping-related iADL, the progressors exhibited a significant, linear decline. Cognitive changes, especially for working memory, were significant predictors of both iADL domains. This study challenges the idea that the performance on activities of daily living is intact and does not change in MCI, and underlines the importance of including iADL in the evaluation of MCI individuals, since a significant change in these activities, combined with the cognitive markers found using neuropsychological tests, may indicate a higher risk of dementia progression one or two years later.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".