Neuroimaging and clinical characteristics of cognitive migration in community‐dwelling older adults
Bibliographic record
Abstract
Abstract Background Longitudinal studies in cognitively unimpaired older adults have identified a wide range of neuroimaging and clinical biomarkers that predict cognitive decline and clinical progression to mild cognitive impairment (MCI) or dementia. However, early biomarkers associated with progression from normal to impaired brain functioning and cognition (cognitive migration) in ADRD require further validation. We investigated the impacts of baseline neuroimaging and clinical biomarkers on functional and cognitive migration in a community‐dwelling cohort of older adults. Method Participants from the Wake Forest Alzheimer’s Disease Research Center (ADRC) Clinical Core cohort who completed their baseline and 1‐year follow‐up clinical visits with available neuropsychological and MRI data were evaluated. Each participant was categorized to a functional/cognitive state based on baseline global CDR (Clinical Dementia Rating); CDR=0 (n=120) indicates normal function and CDR=0.5 (n=57) corresponds to MCI. Cognitive measures included MoCA (Montreal Cognitive Assessment) and preclinical Alzheimer's cognitive composite (PACC5) scores. Oral Glucose Tolerance Testing (OGTT) assessed blood glucose 120‐minute post‐challenge; OGTT >140 mg/dl indicates impaired glucose tolerance. The primary outcome measure was cognitive migration determined by CDR increase/decrease between baseline and follow‐up (mean difference=13.8 months): CDR‐0 Stables (maintained CDR=0), CDR‐0.5 Stables (maintained CDR=0.5), CDR‐0 to CDR‐0.5 (Migrators), and CDR‐0.5 to CDR‐0 (Reverters). Baseline T1 MRI scans were assessed for gray‐matter volume and analyzed using voxel‐based morphometry in SPM12 for group differences. Statistical design was a two‐sample t‐test controlling for age, sex, education and whole brain volume in contrasts of interest (thresholded at k=25 voxels, p<0.01 uncorrected). Result Table lists the baseline demographic and clinical characteristics for significant differences between groups. CDR‐0.5 Stables and Migrators had lower gray‐matter density (GMD) than CDR‐0 Stables and Reverters, most significantly in hippocampal (HC), temporal pole (BA38) and angular (BA39) regions (Figure). Conclusion Our analyses suggest that lower GMD in HC and BA38/39 may predict cognitive migration in early stages of disease pathology. OGTT tracks cognitive migration status in this cohort with Reverters having the lowest and Migrators having the highest mean OGTT. Validating these biomarkers may guide clinical diagnosis and treatments in ADRD. Cognitive and functional changes identified within one year can inform disease profiling.
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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 | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 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".