Understanding the burden experienced by patients with mild cognitive impairment due to Alzheimer's disease and dementia due to Alzheimer's disease at different stages of disease severity in a real‐world setting
Bibliographic record
Abstract
BACKGROUND: People with Alzheimer's Disease (AD) inevitably progress from preclinical stage, to experiencing mild cognitive impairment (MCI) to dementia. Our aim was to characterise the burden experienced by patients, delineated by disease severity. METHOD: Data were drawn from the Adelphi Real World AD Disease Specific Programme™, a cross-sectional survey of physicians and their patients with MCI due to AD or dementia due to AD (clinically diagnosed or biomarker confirmed) in Canada, France, Germany, Italy, Spain, the United Kingdom, Japan and the United States between December 2022 - March 2024. Physicians were asked to report data on demographics and symptoms for their next nine consecutively consulting patients, followed by one patient with a biomarker-confirmed MCI due to AD diagnosis. Patients self-reported the impact of disease on their lifestyle and responses were grouped by theme. Data was analysed by disease severity according to the patient's current Mini-Mental State Examination (MMSE) score. Analyses were descriptive. RESULT: Overall, 829 physicians reported data on 4202 patients (10.3% with an MMSE of 26-30, 37.8% 21-25, 46.7% 11-20, 5.3% 0-10). In total, 558 patients with an MMSE between 11-30 self-reported data. Overall, patients had a mean (standard deviation) age of 75.5 (8.2) years and 50.3% were male. Physicians reported that functional impairment of activities were experienced by 34.6%, 62.2%, 81.0% and 90.1% of patients with an MMSE of 26-30, 21-25, 11-20 and 0-10, respectively; and behavioural symptoms by 44.5%, 65.3%, 77.3% and 86.1% of patients. Most frequently experienced symptoms included impairment of short-term memory (86.1% of patients with an MMSE of 26-30; 85.4% 21-25; 87.8% 11-20; 95.5% 0-10), difficulties in concentration (36.9%; 47.6%; 56.2%; 74.9%) and difficulty recalling names/words (35.0%; 41.4%; 52.5%; 66.8%). Patients reported experiencing greater isolation (54.2% of patients with an MMSE of 26-30; 62.0% 21-25; 74.5% 11-20) and lower self-esteem/confidence (55.9%; 63.7%; 54.5%) since receiving their diagnosis. CONCLUSION: Impairment across cognitive, functional and behavioural symptoms/abilities are experienced by patients with MCI due to AD and dementia due to AD, irrespective of disease severity. Patients report isolation and feelings of lower self-esteem after diagnosis. Early intervention to slow disease progression is important to decrease patient burden.
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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 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 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".