The association of the of late‐life onset psychotic symptoms with incident cognitive impairment in a cognitively normal sample.
Bibliographic record
Abstract
Abstract Background Previous research suggests around 5–10% of cognitively normal older people report some degree of psychotic experiences as measured in the Mild Behavioral Impairment framework. Such late‐onset symptoms potentially confer a relatively high risk for neurodegenerative disease so there is a need for studies examining their clinical correlates prior to dementia onset. We compared the relationship between psychotic symptoms and progression to cognitive impairment in a large community‐dwelling sample of adults over 50. Method 5,085 participants were drawn from the PROTECT study. These individuals had no reported neurological diseases (including MCI), psychotic disorders or cognitive impairment as rated by the Informant Questionnaire of Cognitive Decline in the Elderly (IQCODE). Cognitive impairment was operationalised as a score of >3.3 on the IQCODE. Participants were followed up for a maximum of 5 years. IQCODE scores were taken every. Survival until ‘cognitive impairment’ (i.e. IQCODE >3.3) was the primary outcome. At baseline participants were dichotomised into those scoring >0 on any of the 5 items pertaining to psychosis on the Mild Behavioral Impairment Checklist (‘MBI‐psychosis’ group) and those scoring 0 on all 5 items (‘no symptoms’ group). Survival until IQCODE >3.3 was assessed in a Cox proportional hazards model (adjusting for age, gender, education and mental health diagnoses). The frequency of other medical conditions and Instrumental Activities of Daily Living (IADL) impairment was also compared between the two groups. Result There were 429 (8%) participants in the MBI‐psychosis group (72% men) and 4,656 in the no symptom group (72% men). The mean age was 63 (SD: 6.9). MBI‐psychosis was associated with a 3‐fold (95% CI: 2.4‐3.6, p<0.0001) higher risk of cognitive impairment relative to the no symptom group. There were modestly higher proportions of the following conditions in the MBI‐psychosis group compared with the no symptoms group (p<0.05): heart disease (9%, 6%), high blood pressure (33%, 27%), high cholesterol (30%, 25%), hypothyroidism (11%, 7%), arthritis (26%, 21%). There was no difference in IADL impairments. Conclusion Relatively mild psychotic symptoms that emerge in later are associated with an increased risk of cognitive decline, suggesting that these symptoms in the cognitive normal population may be of clinical significance.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.004 |
| 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 | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".