Baseline blood amylin levels predict longitudinal cognitive decline in participants at risk for or with mild cognitive impairment and dementia
Bibliographic record
Abstract
Abstract Background Amylin is a systemic hormone that is co‐secreted with insulin from pancreatic β‐cells that co‐aggregates with parenchymal and vascular b‐amyloid in the CNS. Cross‐sectional data shows that higher CSF and blood amylin levels are associated with increased frequency of cognitive impairment and dementia. The present study sought to determine whether baseline blood amylin levels are associated with longitudinal cognitive decline. Method Whole blood amylin levels were ascertained from 83 participants in a longitudinal cohort spanning the cognitive continuum from normal to MCI and dementia who were evaluated initially in 2017 and followed to present. Cognitive change data including MMSE, MoCA, CDR global and sum‐of‐box scores at baseline and longitudinal follow‐up were analyzed in relation to baseline amylin levels. Result Participants were followed for a mean 2.0 ± 1.1 years. Baseline whole blood amylin levels varied widely (mean of 8.8 ± 12.2 pg/ml). Seventy‐one participants had complete baseline and follow‐up data were included in this analysis. Of these, 20 had objective evidence for longitudinal decline. Participants with above vs below modal baseline amylin levels scored lower on baseline and follow‐up assessment scores including MMSE, MoCA, CDR global and CDR sum‐of box scores (p‐values all < 0.05). Annualized cognitive change scores (loss) for the MMSE (1.4 ± 2.4 vs. 0.3 ± 1.3; p < 0.05) and MoCA (1.5 ± 2.5 vs. 0.4 ± 1.8; p < 0.05) were greater in the above median baseline amylin level vs below median groups. Conclusion Baseline amylin whole blood levels are predictive of objective decline in MMSE and MoCA scores over periods as short as 2 years. These data suggest that the higher pancreatic hormone amylin may accelerate disease pathogenesis and cognitive decline as a result of altered pancreatic β‐cell function, potentially explaining, at least in part, the strong epidemiologic link between diabetes and dementia found across global observational cohorts. These data further suggest that the use of amylin biomarkers may serve as a useful tool for identifying subjects at high risk for short term cognitive decline. Additional work elucidating the role of amylin in degenerative disease cascades is warranted.
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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 | 0.003 |
| 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 | 0.001 |
| Open science | 0.000 | 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".