Health service utilization and transition to nursing home among a cohort with mixed neurodegenerative pathologies: the linked Ontario Neurodegenerative Disease Research Initiative (ONDRI) Cohort
Bibliographic record
Abstract
BACKGROUND: The Ontario Neurodegenerative Disease Research Initiative (ONDRI) was a prospective cohort study that enrolled persons with varied neurodegenerative pathologies including Alzheimer's disease and/or mild cognitive impairment (ADMCI), Parkinson's disease (PD), amyotrophic lateral sclerosis (ALS), frontotemporal dementia (FTD), and cerebrovascular disease± cognitive impairment (CVD) who underwent clinical and functional assessments in Ontario, Canada. We sought to examine long-term differences in health system use, transition to nursing home, and mortality across neurodegenerative pathologies via linkage with provincial health administrative data. METHODS: 2024, death, or loss of health insurance eligibility, whichever occurred first. Rates of health service use, transition to nursing home, and mortality were calculated by neurodegenerative pathology and expressed per 100 person-years. RESULTS: Persons with PD were most likely to be male, while those with ADMCI showed the lowest proportion males (75.9% vs. 54.1%). Those with ADMCI were older compared to persons with ALS (mean 70.2 vs. 61.7 years). Follow-up time ranged from an average of 2.8 years in persons with ALS to 8.0 years in those with CVD. Persons with ALS had the highest mortality rate, while those CVD had the lowest (35.3 vs. 2.4 per 100 person-years). Persons with all neurodegenerative diseases showed a high use of health services, varying by service type. Persons with ALS showed the highest rate of home care visits, including visits for nursing, personal support, and therapies, followed by persons with FTD. Persons with PD had the highest rate of fall-related emergency department visits and hospitalizations. Persons with FTD had the highest rate of transition to nursing home. CONCLUSIONS: Our findings demonstrate that persons with neurodegenerative pathologies require different health services, with varying intensity, to meet their needs. Linkage of health administrative data to clinical cohorts supports examination of health service milestones and allows for long-term follow-up at relatively low cost.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 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, 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".