I‐CONECT: Efficacy in Primary and Secondary outcomes
Bibliographic record
Abstract
Abstract Background Octogenarians are the fastest growing segment of the population worldwide, but are often excluded from pharmacological intervention trials. Slowing cognitive decline and delaying the onset of dementia even for a few years among this age group could reduce prevalent dementia significantly. Behavioral intervention targeting the older old, which can be easily started and sustained even among the homebound, is needed. Method Based on the epidemiological findings and promising results in our previous pilot project, we developed Internet‐based Conversational‐Engagement Clinical Trial (I‐CONECT)” (ClinicalTrial.gov: NCT02871921). I‐CONECT is a multi‐site, assessor‐blind, randomized controlled behavioral intervention trial intended to enhance cognitive reserve by increasing social interactions, specifically conversational interactions, using video conferencing. Through community outreach and mass‐mailing, 29,664 contacts were attempted, resulting in 1,139 telephone screenings. Ultimately 186 socially isolated participants aged 75 and older (mild cognitive impairment (MCI) or normal cognition (NC)) were randomized (mean age = 81.1, 20% African Americans). The experimental group engaged in 30‐minute video chats 4 times per week for 6 months, followed by twice per week for an additional 6 months, and weekly 10‐minute phone check‐ins. The control group received only the weekly phone check‐ins. Due to the COVID‐19 pandemic, we replaced in‐home assessments with telephone assessments (T‐COG) during the intervention. Accordingly, we conducted two separate analyses: one using only those who completed Month 6 assessments before the COVID pandemic (n = 56, N56Analysis) and another using all randomized participants (n = 186, N186Analysis) with the latter analysis controlling for COVID‐19 pandemic exposure using mixed models for repeated measures. Result Among MCI participants, global cognition as measured by the Montreal Cognitive Assessment (MoCA) (primary outcome) was 1.76 points higher at Month 6 assessments among the experimental group compared with the control group (M56analysis) (p = 0.03, Cohen’s d = 0.73). At Month 12, we also observed 2.19 points higher score (p = 0.03) in Craft Story Immediate Recall (episodic memory/encoding, secondary outcome) in M186Analysis. Conclusion Despite the reduced sample size, we demonstrated efficacy in our primary and secondary outcomes and feasibility of executing methods to enhanced social engagement in isolated older adults using a virtual platform. Long term effects of this intervention will be examined in a future Phase III trial.
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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 | 0.006 | 0.008 |
| Meta-epidemiology (narrow) | 0.002 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.014 | 0.002 |
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".