Expert elicitation of risk factors for progression to dementia in individuals with mild cognitive impairment

Abstract

IntroductionThis study assesses experts’ beliefs about important predictors of developing dementia in persons with mild cognitive impairment (MCI).MethodsStructured expert elicitation, a methodology to quantify expert knowledge, was used to elicit the most important risk factors for developing dementia. We recruited 11 experts (6 neurologists, 3 geriatricians, and 2 psychiatrists). Ten experts fully participated in introductory meetings, two rounds of surveys, and discussion meetings. The data from these ten experts were utilized for this study.ResultsThe expert elicitation identified age, CSF analysis, fluorodeoxyglucose‐positron emission tomography (FDG‐PET) findings, hippocampal atrophy, MoCA (or MMSE) score, parkinsonism, apathy, psychosis, informant report of cognitive symptoms, and global atrophy as the ten most important predictors of progressing to dementia in persons with MCI.DiscussionSeveral dementia predictors are not routinely collected in existing registries, observational studies, or usual care. This might partially explain the low uptake of existing published dementia risk scores in clinical practice.

Artificial intelligence approaches for early detection of neurocognitive disorders among older adults

“…However, the generated SVM models performed the best, with an accuracy of 93.3% for all patients, 94.4% for men exclusively, and 95.5% for women-only models. The top 10 significant predictors based on the developed SVM model for all patients are ranked as (Winblad et al, 2016) education, (Cummings-Vaughn et al, 2014 bedtime, (Ferencz and Gerritsen, 2015) taking pills for chronic pain, (Wang et al, 2022) diabetes, (Wang et al, 2021) stroke, (Doblhammer et al, 2022) gender, (Goerdten et al, 2019) chronic pains, (Kilander et al, 1998) coronary artery diseases, and (Walker et al, 2017) wake-up time. The key novelty of this study is the early detection of cognitive function without relying on the radiological findings.…”

“…Typically, each table row demonstrates an observed class, and each column is a predicted class. Several statistical methods of performance evaluation were used for assessing the established models, including prediction accuracy, recall (true positive rate), precision (positive predictive value), and F1 score, as described in Equation (1-4) (Wang et al, 2022).…”

“…This multi-etiological syndrome is caused by different neurodegenerative diseases, including AD, which accounts for 70 to 80% of all cases of dementia (Ferencz and Gerritsen, 2015). Other types of dementia include vascular dementia, frontotemporal lobar degeneration (FTLD), and Lewy body dementia (Wang et al, 2022). The neuropathological hallmarks of AD are the abnormal accumulation of cortical extracellular senile amyloid-beta (Aβ) plaques and intracellular neurofibrillary tangles (NFTs), which selectively affect specific types of neurons and brain circuits.…”

Oral health: A siloed yet modifiable cognitive impairment risk factor

“…Sir, More recently, global researchers assessed experts' beliefs about important risk predictors for dementia conversion in persons with mild cognitive-impairment. 1 The researchers aptly concluded that several predictors are not routinely examined which can be related to low uptake of evidence-based dementia risk factors in clinical practice. One modifiable risk factor requiring grave consideration, is oral health, a less considered but important predictive risk factor for development and progression of cognitive-impairment.…”

“…This manuscript does not require any ethical consent. Saravana Karthikeyan Balasubramanian 1 Divya Vinayachandran 2…”