1271 Cognitive Impairment and Sleep Disturbances in World Trade Center (WTC) Rescue and Recovery Workers and Volunteers
Bibliographic record
Abstract
Abstract Introduction World Trade Center rescue and recovery workers and volunteers (WTCRRWV) have elevated levels of poor sleep quality, insomnia symptoms and Obstructive Sleep Apnea (OSA). Increasing evidence of early onset of cognitive deficits in some of these workers highlights the importance of early identification of cognitive impairment. We aim to describe cognitive impairment in this heterogeneous population with a broad range of education levels using multiple assessment methods and investigate potential relationships between cognition and sleep disturbance. Methods 206 WTCRRWV completed sleep and mood questionnaires (Insomnia Severity Index, Epworth Sleepiness Scale, Functional Outcomes of Sleep Questionnaire), at-home or in-lab polysomnography and Montreal Cognitive Assessment (MoCA). Identification of cognitive impairment with sex, age, and education adjusted (SAE) MoCA norms (< 9th percentile) were compared to raw scores with 1 point added for ≤12 years education (raw score < 26 indicates impairment). Subset of 73 underwent UDS-3 Neuropsychological Battery (12% Spanish). UDS-3 norms were applied to 4 cognitive domains (memory, executive & visuospatial, attention and language) to investigate potential domain specific impairments. MoCA raw, SAE adjusted, and UDS-3 domain percentiles were investigated according to OSA, sleep macrostructure and symptoms of insomnia, sleepiness, and functional sleep outcomes. Results 50% of WTCRRWV (n=206, age=59±8 [37-77 years], 80% male, 67% white, 9% black, 29% Hispanic/Latino) demonstrated impairment using raw MoCA scores versus 12% with SAE norms. UDS-3 norms (n=73) indicated that 42% exhibited low average performance (< 25th percentile) on memory and 16% on language domain [3% with mild impairment (< 9th percentile)]. 50% report symptoms of insomnia and 42% have OSA. No apparent association found between insomnia, sleepiness, OSA severity, sleep macrostructure and raw, adjusted MoCA or UDS-3 domain scores. Conclusion MoCA raw cut-off scores suggest widespread cognitive impairments in WTCRRWV compared to SAE norms and likely overestimate impairments. No associations were found between sleep and cognition as assessed here. Future work will examine this complex relationship using sleep-dependent emotional and spatial memory paradigms. AI models that combine symptomatology with physiology and include risk factors such as environmental exposure and social vulnerability may more accurately confer cognitive impairment in this cohort. Support (if any) NIOSH U01OH011481, NIOSH R21OH012623, NIOSH U01OH011852
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".