Cognitive Function in Older Adults with Hematological Malignancies
Bibliographic record
Abstract
Abstract Background: Mild cognitive impairment is common with increasing age and can contribute to an increased risk of cognitive deficits that impair function and independence. Comprehensive geriatric assessment (CGA) predict treatment toxicity and tolerance in hematological malignancies. We utilized CGA and neuropsychological testing to describe vulnerabilities in a group of older adults awaiting autologous and allogeneic hematopoietic cell transplant (HCT). Methods: From August 2016 to June 2017, 30 consecutive patients ≥ 60 years with hematological malignancies who were considered for HCT completed CGA and neuropsychological assessment at the University of Nebraska Medical Center. Measures of cognitive functioning included a standardized battery of neuropsychological tests [Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Battery-CERAD-NP)] and Montreal Cognitive Test (MOCA). Patients completed Geriatric Depression Scale-15 (GDS-15), and carepartners completed a Collateral Source version of the GDS. Results: Patients had a median age of 69 years (range 61-78). MOCA and CERAD-NP were completed in 29 and 26 patients, respectively. Twenty patients met criteria for cognitive impairment and 6 patients met criteria for moderate-severe impairment (Table 1). Patients primarily displayed impairment in language, verbal and non-verbal memory, and >20% showed moderate-severe impairment in attention, executive functioning and visuospatial/visuoconstruction. Patients report a median of 3 (range of 0-8) symptoms on the GDS-15. 15% met criteria for depression, whereas 30% met criteria for depression based on reports from carepartners. Over 45% of patients have both impaired physical functioning on the Short Physical Performance Battery (SPPB Conclusions: Older patients with hematological malignancies, including those with HCT-CI score of 0-2 have a high prevalence of cognitive and functional impairment. Impaired memory and executive functioning have implications for their ability to adhere to complex medication regimens after HCT. Carepartners report more depressive symptoms suggesting that patients may be minimizing depressive symptoms. One fourth of patients are at high risk for further cognitive decline and disability due to preexisting cognitive impairment and impairment in IADLs. Prospective longitudinal studies are needed to better understand the trajectory and profile of cognitive changes in older HCT survivors and the impact of these cognitive changes on life activities and quality of life. Download : Download high-res image (233KB) Download : Download full-size image Disclosures Wildes: Janssen: Consultancy; Carevive Systems Inc: Consultancy.
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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 | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".