Baseline Cognitive Performance Is a Determinant of Prospective Health Resource Utilization Among Adults with Chronic Stroke: A Secondary Analysis
Bibliographic record
Abstract
Abstract Background Cognitive impairment is a costly public health problem globally. Among older adults with chronic stroke, the literature is devoid of prospective data that identify factors responsible for driving health care resource utilization. This study aimed to ascertain key determinants of health resource utilization (HRU) at 6 and 12 months among older adults with chronic stroke. Method This study was a secondary prospective analysis of an economic evaluation conducted alongside the Vitality study, a 6‐month randomized controlled trial with a 6‐month follow‐up which included 120 community‐dwelling adults with chronic stroke, aged 55 years and older. Participants were randomized into 1) exercise (EX) or 2) cognitive and social enrichment activities (ENRICH), or 3) stretching and toning program (BAT) (i.e., control group/ comparator). The primary outcome measure of the randomized controlled trial was the Alzheimer’s Disease Assessment Scale‐Cognitive‐Plus (ADAS‐Cog‐Plus), a global measure of cognitive performance using multidimensional item response theory. We constructed two linear regression models with HRU at 6 and 12 months as the dependent variables for each model, respectively. Predictors relating to mobility, quality of life, global cognition and executive functions were examined. Age, sex, comorbidities, and group allocation (i.e., EX, ENRICH or BAT) were included regardless of statistical significance. Costs were reported in 2022 Canadian Dollars. Result The ADAS‐Cog Plus was a significant determinant of total HRU at 6 months (intervention cessation; p = 0.001) and 12‐months (6‐month followup; p = 0.004). Conclusion The ADAS‐Cog Plus, a measure of cognitive performance, was a significant determinant of HRU at 6 and 12 months among older adults with chronic stroke. This highlights the importance of interventions aimed at combating cognitive decline to minimize health care resource among individuals with chronic stroke.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.006 |
| Bibliometrics | 0.002 | 0.002 |
| 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) | 0.003 | 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".