Rates of clinical progression according to biological Alzheimer's disease stages
Bibliographic record
Abstract
Abstract INTRODUCTION Predicting the rate of cognitive decline and the likelihood of progression to dementia remains a critical unmet need in clinical settings. METHODS We assessed progression to mild cognitive impairment (MCI) and all‐cause dementia in 492 individuals from the TRIAD, ADNI, and HABS‐HD cohorts followed for an average of 2.49 years. Amyloid‐positive participants were staged according to the Alzheimer's Association biological staging framework (A+T 2 ‐/A+T 2MTL +/A+T 2MOD +/A+T 2HIGH +). RESULTS Cognitively unimpaired (CU) individuals in the A+T 2MTL +, A+T 2MOD +, and A+T 2HIGH + biological Alzheimer's disease (AD) stages were at significantly higher risk of clinical progression compared to non‐AD CU individuals. In individuals with MCI, advanced tau stage was associated with an 83% likelihood of developing dementia over 4 years. Biological AD staging demonstrated superior accuracy in predicting clinical progression compared to amyloid‐PET (positron emission tomography) status, tau‐PET status, and demographic information. All tau‐PET‐positive individuals showed a significantly faster rate of cognitive decline than non‐AD controls, with the A+T 2HIGH + stage showing the steepest rate of decline ( p < 0.001). DISCUSSION Our results highlight the prognostic value of biological AD staging. Highlights Cognitively unimpaired (CU) individuals in all tau‐PET (positron emission tomography)–positive biological Alzheimer's disease (AD) stages were at significantly higher risk of clinical progression compared to individuals without AD. In individuals with mild cognitive impairment (MCI), only the A+T 2HIGH + stage reached a point where 50% of individuals had progressed to all‐cause dementia, after 2.36 years. Biological AD staging demonstrated superior accuracy in predicting clinical progression to dementia compared to other PET biomarkers and demographic information. All tau‐PET‐positive individuals showed a significantly faster rate of cognitive decline than individuals without AD, with the A+T 2HIGH + stage showing the steepest rate of decline.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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, 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".