Prediction of Mini-Mental State Examination Scores for Cognitive Impairment and Machine Learning Analysis of Oral Health and Demographic Data Among Individuals Older Than 60 Years: Cross-Sectional Study
Bibliographic record
Abstract
Background: As the older population grows, so does the prevalence of cognitive impairment, emphasizing the importance of early diagnosis. The Mini-Mental State Examination (MMSE) is vital in identifying cognitive impairment. It is known that degraded oral health correlates with MMSE scores ≤26. Objective: This study aims to explore the potential of using machine learning (ML) technologies using oral health and demographic examination data to predict the probability of having MMSE scores of 30 or ≤26 in Swedish individuals older than 60 years. Methods: The study had a cross-sectional design. Baseline data from 2 longitudinal oral health and ongoing general health studies involving individuals older than 60 years were entered into ML models, including random forest, support vector machine, and CatBoost (CB) to classify MMSE scores as either 30 or ≤26, distinguishing between MMSE of 30 and MMSE ≤26 groups. Nested cross-validation (nCV) was used to mitigate overfitting. The best performance-giving model was further investigated for feature importance using Shapley additive explanation summary plots to easily visualize the contribution of each feature to the prediction output. The sample consisted of 693 individuals (350 females and 343 males). Results: All CB, random forest, and support vector machine models achieved high classification accuracies. However, CB exhibited superior performance with an average accuracy of 80.6% on the model using 3 × 3 nCV and surpassed the performance of other models. The Shapley additive explanation summary plot illustrates the impact of factors on the model's predictions, such as age, Plaque Index, probing pocket depth, a feeling of dry mouth, level of education, and use of dental hygiene tools for approximal cleaning. Conclusions: The oral health parameters and demographic data used as inputs for ML classifiers contain sufficient information to differentiate between MMSE scores ≤26 and 30. This study suggests oral health parameters and ML techniques could offer a potential tool for screening MMSE scores for individuals aged 60 years and older.
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How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | low |
| gpt | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | low |
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 | 0.006 | 0.009 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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, unvalidatedLabeled directly by 2 models reading the full record.
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".