O2‐11‐03: BEHAVIORAL SYMPTOMS ARE A HARBINGER OF FURTHER COGNITIVE DECLINE IN A 2‐YEAR LONGITUDINAL STUDY OF PERSONS WITH SUBJECTIVE COGNITIVE DECLINE (SCD)
Bibliographic record
Abstract
Otherwise healthy older persons with Subjective Cognitive Decline (SCD) progress to subsequent Mild Cognitive Impairment (MCI) and eventually to dementia of the Alzheimer's type (AD), (e.g. Reisberg, et al., Alzheimers Dement, 2010; Mitchell et al., Acta Psychiatr Scand, 2014; Jessen et al., Alzheimers Dement, 2014; and Reisberg et al., J Alzheimers Dis, 2019). However, the relationship between behavioral disturbances and this progression in SCD persons has not previously been described. Herein we investigated this relationship. Characteristics of our research population have been described (Reisberg et al., J Alzheimers Dis, 2019). Subjects were ≥ 40 years of age at baseline and healthy apart from the presence of SCD. Medical, psychiatric, neurologic, and neuroradiologic evaluations excluded persons with conditions apart from SCD which might interfere with cognition at baseline. Subjects examined herein are a cohort with BEHAVE-AD assessments, who were followed for 2.13 ± 0.30 years. The cohort comprised 73 subjects, mean age 66.66 ± 8.31 years, 48 females and 25 males. The most commonly occurring BEHAVE-AD symptoms at baseline and their percentage occurrence were: anxieties (49.3%), sleep disturbances (20.5%), tearfulness (12.3%), and verbal outbursts (9.6%). At follow-up, subjects were divided into 2 categories: (A) subjects who declined to MCI (Global Deterioration Scale [GDS] stage 3), or dementia (GDS stage ≥ 4), (N=18), and (B) subjects who remained unimpaired (GDS stage ≤ 2), (N=55). For subjects whose cognition worsened at follow-up, 16 (88.9%) manifested baseline BEHAVE-AD symptoms. For subjects whose cognition did not worsen at follow-up 30 (54.5%) had manifest baseline BEHAVE-AD symptoms. Between group differences in manifest baseline BEHAVE-AD symptoms were significant (p=0.01). The occurrence of BEHAVE-AD symptomatology is significantly associated with subsequent MCI or dementia over a subsequent 2 year interval in persons with SCD. These novel findings point to behavioral disturbances as a harbinger of decline in persons with SCD. Since prior research has demonstrated that BEHAVE-AD symptoms respond to both pharmacologic (e.g. risperidone) and non-pharmacologic (e.g. Reisberg et al., Dement Geriatr Cogn Dis, 2017) treatments, future studies should investigate whether treatment of behavioral symptoms can mitigate subsequent cognitive decline in persons with SCD.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 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".