Sex as a moderator of the association between frailty and mild behavioral impairment
Bibliographic record
Abstract
Abstract Background Frailty and mild behavioral impairment (MBI) are associated with dementia and sex differences are recognized in both. Each can facilitate early detection and treatment. This study investigated the association between frailty and MBI and whether this association is moderated by sex. Method Cross‐sectional data from 219 participants (48.9% female; mean and SD of age = 72.2 ± 6.5 years, and education = 15.8 ± 3.5 years) from the Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS‐ND) study was analyzed. No participants had dementia: 58 (26.5%) were cognitively normal and 161 (73.5%) had mild cognitive impairment. Frailty was measured using the frailty index (FI); higher scores indicate more health deficits/greater frailty. MBI symptoms were derived from Neuropsychiatric Inventory Questionnaire scores using a published algorithm with a cut‐off of >0 indicating MBI symptom presence. As with the FI, greater MBI severity was indicated by higher scores. Multivariable logistic and linear regressions adjusted for age, sex, education, and cognitive diagnosis were used to test the association between FI and MBI symptom presence and severity, respectively, with MBI as the outcome variable. An FI‐by‐sex interaction term was included in the linear regression model to test for sex‐dependent effects. Result The FI mean and SD across the entire cohort was 0.14 ± 0.06 (median = 0.14, IQR = 0.09–0.17, range = 0.02–0.38). Approximately half (51.6%) showed MBI symptoms (mean and SD of severity = 1.8 ± 2.7). Higher FI scores were associated with the presence of MBI symptoms both globally and in the domains of decreased motivation, affective dysregulation, and psychosis (Table 1). Higher FI scores were also associated with more severe MBI symptoms in a sex‐dependent manner: both sexes reported similarly low MBI symptom severity at low (‐1 SD) levels of FI but males reported 1.9x higher MBI symptom severity relative to females at high (+1 SD) levels of FI (Figure 1). Conclusion The FI is associated with both the presence and severity of MBI, especially for males. These findings suggest that patients with frailty should be assessed for MBI and that patients with MBI should be assessed for frailty.
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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 | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 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) | 0.005 | 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".