Machine Learning-Based Multi-Modal Prediction of Cognitive Decline in Community-Dwelling Older Adults
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Objective: This study aimed to develop a machine learning model to predict cognitive decline in community-dwelling older adults. By integrating multimodal data, including demographic, psychosocial, and neuroimaging information, we sought to enhance early detection of cognitive decline. Methods: Data were obtained from 159 participants in the Biobank Innovations for Chronic Cerebrovascular Disease with Alzheimer’s Disease Study. Participants underwent clinical assessments, neuropsychological testing, and magnetic resonance imaging scans. Cognitive decline was defined as an increase in the Clinical Dementia Rating-Sum of Boxes of greater than 2.05 points per year at follow-up. Models were developed using the logistic classification, combining demographic, psychosocial assessments, and neuroimaging data. Model performance was evaluated using area under the curve (AUC), accuracy, and F1 score, while Shapley additive explanation values were used to assess feature importance. Results: The model that incorporated all data types achieved the highest performance, with an AUC of 0.834. The top predictor of cognitive decline was years of education, underscoring the importance of non-invasive, easily accessible data for prediction. Conclusion: This machine learning model demonstrates significant potential for early cognitive decline prediction, offering a scalable tool for improving dementia screening and timely intervention, especially in resource-limited settings.
Abstract
Objective: This study aimed to develop a machine learning model to predict cognitive decline in community-dwelling older adults. By integrating multimodal data, including demographic, psychosocial, and neuroimaging information, we sought to enhance early detection of cognitive decline. Methods: Data were obtained from 159 participants in the Biobank Innovations for Chronic Cerebrovascular Disease with Alzheimer’s Disease Study. Participants underwent clinical assessments, neuropsychological testing, and magnetic resonance imaging scans. Cognitive decline was defined as an increase in the Clinical Dementia Rating-Sum of Boxes of greater than 2.05 points per year at follow-up. Models were developed using the logistic classification, combining demographic, psychosocial assessments, and neuroimaging data. Model performance was evaluated using area under the curve (AUC), accuracy, and F1 score, while Shapley additive explanation values were used to assess feature importance. Results: The model that incorporated all data types achieved the highest performance, with an AUC of 0.834. The top predictor of cognitive decline was years of education, underscoring the importance of non-invasive, easily accessible data for prediction. Conclusion: This machine learning model demonstrates significant potential for early cognitive decline prediction, offering a scalable tool for improving dementia screening and timely intervention, especially in resource-limited settings.
참고문헌 (48)
- GBD 2019 Dementia Forecasting Collaborators, "Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050 : an analysis for the global burden of disease study 2019", Lancet Public Health, 7, pp.e105~e125 (2022)
- The global impact of dementia: an analysis of prevalence, incidence, cost and trends, "Prince M", Alzheimer’s Disease International, ~, pp.World Alzheimer report 2015 (2015)
- Alzheimer’s Association, "2024 Alzheimer’s disease facts and figures", Alzheimers Dement, 20, pp.3708~3821 (2024)
- Seshadri S, "Lifetime risk of stroke and dementia : current concepts, and estimates from the Framingham study", Lancet Neurol, 6, pp.1106~1114 (2007)
- Jessen F, "A conceptual framework for research on subjective cognitive decline in preclinical Alzheimer’s disease", Alzheimers Dement, 10, pp.844~852 (2014)
- Hansson O, "Biomarkers for neurodegenerative diseases", Nat Med, 27, pp.954~963 (2021)
- Manly JJ, "Estimating the prevalence of dementia and mild cognitive impairment in the US : the 2016 health and retirement study harmonized cognitive assessment protocol project", JAMA Neurol, 79, pp.1242~1249 (2022)
- World Alzheimer report 2011: the benefits of early diagnosis and intervention, "Prince M", Alzheimer’s Disease International, ~ (2011)
- Villemagne VL, "Amyloid β deposition, neurodegeneration, and cognitive decline in sporadic Alzheimer’s disease : a prospective cohort study", Lancet Neurol, 12, pp.357~367 (2013)
- Dubois B, "Biomarkers in Alzheimer’s disease : role in early and differential diagnosis and recognition of atypical variants", Alzheimers Res Ther, 15, pp.175~ (2023)
- Leonenko G, "Dementias platform UK : bringing genetics into life", Alzheimers Dement, 20, pp.3281~3289 (2024)
- Bansal D, "Comparative analysis of various machine learning algorithms for detecting dementia", Procedia Comput Sci, 132, pp.1497~1502 (2018)
- Bhagyashree SIR, "Diagnosis of dementia by machine learning methods in epidemiological studies : a pilot exploratory study from South India", Soc Psychiatry Psychiatr Epidemiol, 53, pp.77~86 (2018)
- Zhu F, "Machine learning for the preliminary diagnosis of dementia", Sci Program, 2020, pp.5629090~ (2020)
- Grueso S, "Machine learning methods for predicting progression from mild cognitive impairment to Alzheimer’s disease dementia : a systematic review", Alzheimers Res Ther, 13, pp.162~ (2021)
- Aschwanden D, "Predicting cognitive impairment and dementia : a machine learning approach", J Alzheimers Dis, 75, pp.717~728 (2020)
- "Machine learning techniques for diagnostic differentiation of mild cognitive impairment and dementia"[URL]
- Roh HW, "Baseline clinical and biomarker characteristics of biobank innovations for chronic cerebrovascular disease with Alzheimer’s disease study : BICWALZS", Psychiatry Investig, 19, pp.100~109 (2022)
- Folstein MF, ""Mini-mental state". A practical method for grading the cognitive state of patients for the clinician", J Psychiatr Res, 12, pp.189~198 (1975)
- Yesavage JA, "Development and validation of a geriatric depression screening scale : a preliminary report", J Psychiatr Res 1982-, 17, pp.37~49 (1983)
- Cho MJ, "Validation of geriatric depression scale, Korean version(GDS)in the assessment of DSM-III-R major depression", J Korean Neuropsychiatr Assoc, 38, pp.48~63 (1999)
- Wade DT, "The Barthel ADL index : a standard measure of physical disability?", Int Disabil Stud, 10, pp.64~67 (1988)
- Ku HM, "A study on the reliability and validity of Seoul-instrumental activities of daily living(S-IADL)", J Korean Neuropsychiatr Assoc, 43, pp.189~199 (2004)
- Lawton MP, "Assessment of older people : self-maintaining and instrumental activities of daily living", Gerontologist, 9, pp.179~186 (1969)
- Morris JC, "The clinical dementia rating(CDR) : current version and scoring rules", Neurology, 43, pp.2412~2414 (1993)
- Reisberg B, "The global deterioration scale for assessment of primary degenerative dementia", Am J Psychiatry, 139, pp.1136~1139 (1982)
- Ryu HJ, "The Seoul neuropsychological screening battery(SNSB)for comprehensive neuropsychological assessment", Dement Neurocogn Disord, 22, pp.1~15 (2023)
- Yesavage JA, "9", geriatric depression scale(GDS), 1986, pp.5, 165~173
- Buysse DJ, "The Pittsburgh sleep quality index : a new instrument for psychiatric practice and research", Psychiatry Res, 28, pp.193~213 (1989)
- Craig CL, "International physical activity questionnaire : 12-country reliability and validity", Med Sci Sports Exerc, 35, pp.1381~1395 (2003)
- Vellas B, "The mini nutritional assessment(MNA)and its use in grading the nutritional state of elderly patients", Nutrition, 15, pp.116~122 (1999)
- Fried LP, "Frailty in older adults : evidence for a phenotype", J Gerontol A Biol Sci Med Sci, 56, pp.M146~M157 (2001)
- Montgomery SA, "A new depression scale designed to be sensitive to change", Br J Psychiatry, 134, pp.382~389 (1979)
- Beck AT, "An inventory for measuring clinical anxiety : psychometric properties", J Consult Clin Psychol, 56, pp.893~897 (1988)
- Kwon JH, "Development and validation of the Hwa-Byung scale", Kor J Clin Psychol, 27, pp.237~252 (2008)
- Smith BW, "The brief resilience scale : assessing the ability to bounce back", Int J Behav Med, 15, pp.194~200 (2008)
- O’Bryant SE, "Staging dementia using clinical dementia rating scale sum of boxes scores : a Texas Alzheimer’s research consortium study", Arch Neurol, 65, pp.1091~1095 (2008)
- Karim HT, "Independent replication of advanced brain age in mild cognitive impairment and dementia : detection of future cognitive dysfunction", Mol Psychiatry, 27, pp.5235~5243 (2022)
- Goto M, "Diffeomorphic anatomical registration through exponentiated lie algebra provides reduced effect of scanner for cortex volumetry with atlas-based method in healthy subjects", Neuroradiology, 55, pp.869~875 (2013)
- Rolls ET, "Automated anatomical labelling atlas 3", Neuroimage, 206, pp.116189~ (2020)
- Planche V, "Structural progression of Alzheimer’s disease over decades : the MRI staging scheme", Brain Commun, 4, pp.fcac109~ (2022)
- Yadaw AS, "Clinical features of COVID-19 mortality : development and validation of a clinical prediction model", Lancet Digit Health, 2, pp.e516~e525 (2020)
- Dashtipour K, "Body area networks. Smart IoT and big data for intelligent health management", pp.89~100 (2022), Springer
- Moscoso A, "Prediction of Alzheimer’s disease dementia with MRI beyond the short-term : implications for the design of predictive models", Neuroimage Clin, 23, pp.101837~ (2019)
- Zheng Y, "Machine learningbased framework for differential diagnosis between vascular dementia and Alzheimer’s disease using structural MRI features", Front Neurol, 10, pp.1097~ (2019)
- Chiu PY, "NMD-12 : a new machine-learning derived screening instrument to detect mild cognitive impairment and dementia", PLoS One, 14, pp.e0213430~ (2019)
- Chlasta K, "Towards computer-based automated screening of dementia through spontaneous speech", Front Psychol, 11, pp.623237~ (2021)
- Jammeh EA, "Machine-learning based identification of undiagnosed dementia in primary care : a feasibility study", BJGP Open, 2, pp.bjgpopen18X101589~ (2018)
