Dual decline in gait and cognition as a risk factor for dementia. The role of sex
Bibliographic record
Abstract
Abstract Background Motor (slowing of gait) and cognitive declines are common in older adults. We reported that older adults with both motor and cognitive decline (dual‐decliners) had a higher risk of progressing to dementia than individuals with either decline alone. Our aim in this study is to examine the role of sex in these cognitive and motor trajectories before dementia. Methods Data was used from the Gait and Brain Study, a prospective cohort study in community‐dwelling older adults free of dementia at baseline. Participant’s motor and cognitive trajectories were assessed twice a year for 5 years, using gait speed and the MoCA test, respectively. We ascertained incident dementia using DSM‐IV‐RT criteria. The risk to progress to dementia was evaluated with Cox regression models, stratifying by sex and adjusting by age and comorbidities. Results From 207 older adults, 37 individuals (18%) progressed to dementia, from which 43% were males and 57% were females. Among dual‐decliners, males had a higher risk for progressing to dementia when compared with females (Males HR: 3.90, 95%CI: 1.02‐14.87, p = 0.046; Females: HR: 2.41, 95%CI: 0.72‐ 8.12, p = 0.155). In addition, in males, the association becomes stronger after adjusting for comorbidities (HR: 4.36, 95%CI: 1.08‐17.66, p = 0.039), whereas in females, the risk for progressing to dementia lowers when adjusting for comorbidities (HR: 1.44, 95%CI: 0.38‐ 5.41, p = 0.590), suggesting that number of comorbidities might be driving the association with dementia in females. Male dual‐decliners showed a stronger association with progression to dementia (HR = 4) when compared with females (HR = 1) in both adjusted and unadjusted models. Conclusion Older adults that present both motor and cognitive decline (dual‐decliners) have the highest risk to progress to dementia, particularly if they are men. Sex differences in motor and cognitive trajectories before dementia may increase accuracy of dementia risk prediction. Future studies are needed to understand mechanisms underlying our findings.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| 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 | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".