226Alcohol Related Cognitive Impairment in Adult Hospital Inpatients: A Point Prevalence Study
Bibliographic record
Abstract
Background: Most long-term heavy alcohol users will experience impaired cognition to some degree. Apart from direct alcohol related neurotoxicity, excessive alcohol intake can be associated with head injuries, seizure-related anoxia, vitamin deficiencies, and poorly modified lifestyle factors for vascular dementia. This study aimed to determine the prevalence of alcohol-related cognitive impairment in unselected acute hospital adult patients. Methods: All adult in-patients on general wards in the Mercy University Hospital on 14th April 2018 were eligible for inclusion. Their medical charts were reviewed to record any documented alcoholism, alcohol excess, or harmful drinking patterns, as well as documented cognitive impairment. All patients were separately approached for a bedside assessment, i.e. completing the brief, well validated “AUDIT” (Alcohol Use Disorders Identification Test) tool for potentially harmful alcohol intake, and completing a brief cognitive screen (the 4AT test), followed by the Montreal Cognitive Assessment (MoCA) if 4AT≥1. These latter patients also gave permission for gathering of collateral information using the validated Informative Questionnaire on Cognitive Decline in the Elderly (IQCODE) tool, together allowing a research categorization of “dementia” or “cognitive impairment” and/or “delirium”. Results: At the time of writing, 153 patients were included, of median age 67; 46% were female. Between chart review and audit scores, 19% had harmful drinking currently or in the past. Of these, 18% had dementia and 12% delirium. In contrast, in those without harmful drinking, 16% had dementia and 9% delirium. Concerningly, 41% of patients with abnormal cognition had no chart documentation of alcohol intake. Conclusion: There is a strong link between alcohol excess and cognitive impairment/delirium/dementia in hospitalised patients. Every patient with alcohol excess should be considered to have potential delirium and/or cognitive impairment, and all in-patients with cognitive impairment need careful alcohol documentation.
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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 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| 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".