Automated computational assessment of neuropsychological tests would enable widespread, cost‐effective screening for dementia.
A novel natural language processing approach is developed and validated to identify different stages of dementia based on automated transcription of digital voice recordings of subjects’ neuropsychological tests conducted by the Framingham Heart Study (
Average area under the curve (AUC) on the held‐out test data reached 92.6%, 88.0%, and 74.4% for differentiating Normal cognition from Dementia, Normal or Mild Cognitive Impairment (MCI) from Dementia, and Normal from MCI, respectively.
The proposed approach offers a fully automated identification of MCI and dementia based on a recorded neuropsychological test, providing an opportunity to develop a remote screening tool that could be adapted easily to any language.
- NSF-PAR ID:
- 10368727
- Publisher / Repository:
- Wiley Blackwell (John Wiley & Sons)
- Date Published:
- Journal Name:
- Alzheimer's & Dementia
- Volume:
- 19
- Issue:
- 3
- ISSN:
- 1552-5260
- Page Range / eLocation ID:
- p. 946-955
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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RESULTS Of 59,782 MCI patients, 15,420 (25.8%) converted to ACD. The model had good discriminative performance (AUC 0.73 [95% confidence interval (CI) 0.72–0.74]), and calibration (Brier score 0.18 [95% CI 0.17–0.18]). Age, stroke, cerebrovascular disease, myocardial infarction, hypertension, and diabetes were risk factors, while body mass index, alcohol abuse, and sleep apnea were protective factors.
DISCUSSION EHR‐based prediction model had good performance in identifying 5‐year MCI to ACD conversion and has potential to assist triaging of at‐risk patients.
Highlights Of 59,782 veterans with mild cognitive impairment (MCI), 15,420 (25.8%) converted to all‐cause dementia within 5 years.
Electronic health record prediction models demonstrated good performance (area under the receiver operating characteristic curve 0.73; Brier 0.18).
Age and vascular‐related morbidities were predictors of dementia conversion.
Synthetic data was comparable to real data in modeling MCI to dementia conversion.
Key Points An electronic health record–based model using demographic and co‐morbidity data had good performance in identifying veterans who convert from mild cognitive impairment (MCI) to all‐cause dementia (ACD) within 5 years.
Increased age, stroke, cerebrovascular disease, myocardial infarction, hypertension, and diabetes were risk factors for 5‐year conversion from MCI to ACD.
High body mass index, alcohol abuse, and sleep apnea were protective factors for 5‐year conversion from MCI to ACD.
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