Functional impairment in a dementia‐free sample associated with a higher risk of Mild Behavioral Impairment
Bibliographic record
Abstract
BACKGROUND: Mild Behavioral Impairment (MBI) and functional ability are two non-cognitive markers of dementia. To date, little is known about the impact of functional ability on the clinical manifestation of MBI. Using data from the Australian population-based PATH Through Life Study we examined the impact of functional ability on MBI. We hypothesized that poorer functional ability in a dementia-free sample (with at most Mild Cognitive Impairment; MCI) would be associated with a higher likelihood of MBI. METHOD: 1377 dementia-free participants (52% male; aged 72-79; 847 cognitively healthy, 397 cognitively normal, but-at-risk (i.e., subjective cognitive decline), 133 MCI) were included. Functional ability was assessed using the Bayer Activities of Daily Living scale (B-ADL), which comprises 25 items assessed by an informant. Items are scored 1-10 with higher scores indicating poorer functional ability. Presence and absence of MBI and its five domains (decreased motivation, affect dysregulation, impulse dyscontrol, social inappropriateness, abnormal perception/thought content) were approximated using a previously published transformation algorithm, which utilizes items from the Neuropsychiatric Inventory assessed at a single study visit. Binomial logistic regression analyses were conducted to examine risk of MBI associated with functional impairment. Models controlled for Mini Mental State Exam scores (MMSE) and self-reported gender (male/female). RESULT: Adjusted logistic regression (MMSE and gender) showed that a one-unit increase on the B-ADL was associated with a 2.27-fold greater risk of MBI (95% CI 1.962-2.624; p<.001). Similarly, for all 5 MBI domains, a one-unit increase of B-ADL was associated with greater risk of all domains: decreased motivation (B = 2.26; 95% CI 1.898-2.684; p<.001), affect dysregulation (B = 2.02; 95% CI 1.763-2.306; p<.001), impulse dyscontrol (B = 2.01; 95% CI 1.756-2.301; p<.001), social inappropriateness (B = 2.01; 95% CI 1.707-2.378; p<.001), and abnormal perception/thought content (B = 1.82; 95% CI 1.417-2.335; p<.001). CONCLUSION: This study is amongst the first to identify a higher risk of MBI associated with functional ability in dementia-free older adults. These findings highlight the importance of early monitoring of changes in functional ability and behaviour, even prior to the onset of cognitive symptomatology. They also provide further evidence of the clinical utility of functional ability and MBI as early markers of dementia.
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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 | 0.004 |
| 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 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".