Using Deep Learning Techniques as an Attempt to Create the Most Cost-Effective Screening Tool for Cognitive Decline
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Objective This study aimed to use deep learning (DL) to develop a cost-effective and accessible screening tool to improve the detection of cognitive decline, a precursor of Alzheimer’s disease (AD). This study integrating a comprehensive battery of neuropsychological tests adjusted for individual demographic variables such as age, sex, and education level.Methods A total of 2,863 subjects with subjective cognitive complaints who underwent a comprehensive neuropsychological assessment were included. A random forest classifier was used to discern the most predictive test combinations to distinguish between dementia and nondementia cases. The model was trained and validated on this dataset, focusing on feature importance to determine the cognitive tests that were most indicative of decline.Results Subjects had a mean age of 72.68 years and an average education level of 7.62 years. The DL model achieved an accuracy of 82.42% and an area under the curve of 0.816, effectively classifying dementia. Feature importance analysis identified significant tests across cognitive domains: attention was gauged by the Trail Making Test Part B, language by the Boston Naming Test, memory by the Rey Complex Figure Test delayed recall, visuospatial skills by the Rey Complex Figure Test copy score, and frontal function by the Stroop Test Word reading time.Conclusion This study showed the potential of DL to improve AD diagnostics, suggesting that a wide range of cognitive assessments could yield a more accurate diagnosis than traditional methods. This research establishes a foundation for future broader studies, which could substantiate the approach and further refine the screening tool.
Abstract
Objective This study aimed to use deep learning (DL) to develop a cost-effective and accessible screening tool to improve the detection of cognitive decline, a precursor of Alzheimer’s disease (AD). This study integrating a comprehensive battery of neuropsychological tests adjusted for individual demographic variables such as age, sex, and education level.Methods A total of 2,863 subjects with subjective cognitive complaints who underwent a comprehensive neuropsychological assessment were included. A random forest classifier was used to discern the most predictive test combinations to distinguish between dementia and nondementia cases. The model was trained and validated on this dataset, focusing on feature importance to determine the cognitive tests that were most indicative of decline.Results Subjects had a mean age of 72.68 years and an average education level of 7.62 years. The DL model achieved an accuracy of 82.42% and an area under the curve of 0.816, effectively classifying dementia. Feature importance analysis identified significant tests across cognitive domains: attention was gauged by the Trail Making Test Part B, language by the Boston Naming Test, memory by the Rey Complex Figure Test delayed recall, visuospatial skills by the Rey Complex Figure Test copy score, and frontal function by the Stroop Test Word reading time.Conclusion This study showed the potential of DL to improve AD diagnostics, suggesting that a wide range of cognitive assessments could yield a more accurate diagnosis than traditional methods. This research establishes a foundation for future broader studies, which could substantiate the approach and further refine the screening tool.
참고문헌 (20)
- Salloway S, "Disease-modifying therapies in Alzheimer’s disease", Alzheimers Dement, 4, pp.65~79 (2008)
- Frisoni GB, "Revised NIA-AA criteria for the diagnosis of Alzheimer’s disease : a step forward but not yet ready for widespread clinical use", Int Psychogeriatr, 23, pp.1191~1196 (2011)
- 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)
- Nasreddine ZS, "The montreal cognitive assessment, MoCA : a brief screen ing tool for mild cognitive impairment", J Am Geriatr Soc, 53, pp.695699~ (2005)
- Edmonds EC, "Susceptibility of the conventional criteria for mild cogni tive impairment to false-positive diagnostic errors", Alzheimers Dement, 11, pp.415~424 (2015)
- Bondi MW, "Neuropsychological criteria for mild cognitive impair ment improves diagnostic precision, biomarker associations, and pro gression rates", J Alzheimers Dis, 42, pp.275~289 (2014)
- Jak AJ, "Quantification of five neuropsychological approaches to de f ining mild cognitive impairment", Am J Geriatr Psychiatry, 17, pp.368375~ (2009)
- Thomas KR, "Application of neuropsychological criteria to classify mild cognitive impairment in the active study", Neuropsychology, 34, pp.862873~ (2020)
- LeCun Y, "Deep learning", Nature, 521, pp.436~444 (2015)
- Orrù G, "Using support vector machine to identify imaging biomarkers of neurologi cal and psychiatric disease : a critical review", Neurosci Biobehav Rev, 36, pp.1140~1152 (2012)
- Regier DA, "The DSM-5 : classification and criteria changes", World Psychiatry, 12, pp.92~98 (2013)
- Kang Y, "Seoul Neuropsychological Screening Battery(SNSB)" (2003), Human Brain Research & Consulting Co
- Perry RJ, "Attention and executive deficits in Alzheimer’s disease. A critical review", Brain, 122, pp.383~404 (1999)
- Guarino A, "Executive functions in Alzheimer disease : a systematic re view", Front Aging Neurosci, 10, pp.437~ (2019)
- Kirova AM, "Working memory and executive function decline across normal aging, mild cognitive impairment, and Alzheimer’s disease", Biomed Res Int, 2015, pp.748212~ (2015)
- Berente DB, "The assessment of visuospatial skills and verbal fluency in the diagnosis of Alzheimer’s disease", Front Aging Neurosci, 13, pp.737104~ (2022)
- Aul C, "The functional relevance of visuospatial processing speed across the lifespan", Cogn Res Princ Implic, 8, pp.51~ (2023)
- Saxton J, "Functional and cognitive criteria produce different rates of mild cognitive impairment and conversion to dementia", J Neurol Neurosurg Psychiatry, 80, pp.737~743 (2009)
- Kliegel M, "What do subjective cognitive com plaints in persons with aging-associated cognitive decline reflect?", Int Psychogeriatr, 17, pp.499~512 (2005)
- Reid LM, "Subjective memory complaints and cogni tive impairment in older people", Dement Geriatr Cogn Disord, 22, pp.471~485 (2006)
