The effect of study partner characteristics on the reporting of neuropsychiatric symptoms in older adults with and without dementia
Bibliographic record
Abstract
Abstract Background Valid assessments of neuropsychiatric symptoms (NPS) are key in older adults with or without dementia, often relying on study partner (SP) report. NPS are linked to poorer health outcomes, denoting higher risk for incident cognitive decline and dementia, especially when these NPS emerge in later life and persist (i.e., mild behavioral impairment; MBI). We investigated the effect of study partner (SP) characteristics on SP‐reported NPS in older adults with and without dementia (normal cognition or mild cognitive impairment), and compared MBI‐associated rates of incident dementia across different SP characteristics. Method Cross‐sectional (n = 26825) and longitudinal (n = 2526) analyses were conducted on participant‐SP dyads in the National Alzheimer’s Coordinating Center Uniform Data Set. NPS were measured using the SP‐rated Neuropsychiatric Inventory Questionnaire (NPI‐Q). MBI status in dementia‐free participants was defined by the presence of NPS across two consecutive visits. SP characteristics of interest were age, sex, and relationship to participant (spouse, child, other). Multivariable logistic regressions, adjusted for participant age, sex, education, and dementia status were used to model participant NPS presence/absence as a function of SP characteristics. Cox proportional hazards regression was used to compare the hazard of incident dementia in MBI participants across different SPs. Result Participant and SP characteristics are summarized in Table 1. Across the entire cohort, SPs who were younger, female, or a spouse or child of the participant were more likely to report participant NPS [Table 2]. Furthermore, in dementia‐free participants, female‐spouse SPs reported participant MBI with greater odds than male spouses, but non‐spouse SPs reported participant MBI similarly to one another with lower odds regardless of sex [Figure 1]. This interaction was not observed for NPS in dementia, which were highly prevalent regardless of SP sex and relationship to participant. Finally, participants with MBI reported by SPs who were spouses or children progressed to dementia at a greater rate than other SPs. Conclusion SP characteristics including age, sex, and relationship to participant are linked to greater endorsement of NPS in older participants with and without dementia. In scenarios where accurate assessments of NPS are required, SPs characteristics could be considered in recruitment and analysis.
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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 | 0.004 | 0.015 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| 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".