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1. Novel methodology for detection and prediction of mild cognitive impairment using resting‐state EEG

   https://doi.org/10.1002/alz.13411  

   Deng, Jinxian; Sun, Boxin; Kavcic, Voyko; Liu, Mingyan; Giordani, Bruno; Li, Tongtong (July 2023, Alzheimer's & Dementia)

   Abstract BACKGROUNDEarly discrimination and prediction of cognitive decline are crucial for the study of neurodegenerative mechanisms and interventions to promote cognitive resiliency. METHODSOur research is based on resting‐state electroencephalography (EEG) and the current dataset includes 137 consensus‐diagnosed, community‐dwelling Black Americans (ages 60–90 years, 84 healthy controls [HC]; 53 mild cognitive impairment [MCI]) recruited through Wayne State University and Michigan Alzheimer's Disease Research Center. We conducted multiscale analysis on time‐varying brain functional connectivity and developed an innovative soft discrimination model in which each decision on HC or MCI also comes with a connectivity‐based score. RESULTSThe leave‐one‐out cross‐validation accuracy is 91.97% and 3‐fold accuracy is 91.17%. The 9 to 18 months’ progression trend prediction accuracy over an availability‐limited subset sample is 84.61%. CONCLUSIONThe EEG‐based soft discrimination model demonstrates high sensitivity and reliability for MCI detection and shows promising capability in proactive prediction of people at risk of MCI before clinical symptoms may occur. 

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2. Detection of mild cognitive impairment using various types of gait tests and machine learning

   https://doi.org/10.3389/fneur.2024.1354092  

   Seifallahi, Mahmoud; Galvin, James E; Ghoraani, Behnaz (July 2024, Frontiers in Neurology)

   IntroductionAlzheimer's disease and related disorders (ADRD) progressively impair cognitive function, prompting the need for early detection to mitigate its impact. Mild Cognitive Impairment (MCI) may signal an early cognitive decline due to ADRD. Thus, developing an accessible, non-invasive method for detecting MCI is vital for initiating early interventions to prevent severe cognitive deterioration. MethodsThis study explores the utility of analyzing gait patterns, a fundamental aspect of human motor behavior, on straight and oval paths for diagnosing MCI. Using a Kinect v.2 camera, we recorded the movements of 25 body joints from 25 individuals with MCI and 30 healthy older adults (HC). Signal processing, descriptive statistical analysis, and machine learning techniques were employed to analyze the skeletal gait data in both walking conditions. Results and discussionThe study demonstrated that both straight and oval walking patterns provide valuable insights for MCI detection, with a notable increase in identifiable gait features in the more complex oval walking test. The Random Forest model excelled among various algorithms, achieving an 85.50% accuracy and an 83.9% F-score in detecting MCI during oval walking tests. This research introduces a cost-effective, Kinect-based method that integrates gait analysis—a key behavioral pattern—with machine learning, offering a practical tool for MCI screening in both clinical and home environments. 

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3. Predicting 5‐year dementia conversion in veterans with mild cognitive impairment

   https://doi.org/10.1002/dad2.12572  

   Irwin, Chase; Tjandra, Donna; Hu, Chengcheng; Aggarwal, Vinod; Lienau, Amanda; Giordani, Bruno; Wiens, Jenna; Migrino, Raymond_Q (March 2024, Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring)

   Abstract INTRODUCTIONIdentifying mild cognitive impairment (MCI) patients at risk for dementia could facilitate early interventions. Using electronic health records (EHRs), we developed a model to predict MCI to all‐cause dementia (ACD) conversion at 5 years. METHODSCox proportional hazards model was used to identify predictors of ACD conversion from EHR data in veterans with MCI. Model performance (area under the receiver operating characteristic curve [AUC] and Brier score) was evaluated on a held‐out data subset. RESULTSOf 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. DISCUSSIONEHR‐based prediction model had good performance in identifying 5‐year MCI to ACD conversion and has potential to assist triaging of at‐risk patients. HighlightsOf 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 PointsAn 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.Models using synthetic data, analogs of real patient data that retain the distribution, density, and covariance between variables of real patient data but are not attributable to any specific patient, performed just as well as models using real patient data. This could have significant implications in facilitating widely distributed computing of health‐care data with minimized patient privacy concern that could accelerate scientific discoveries. 

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4. Dementia and mild cognitive impairment screening in an emergency homeless shelter

   https://doi.org/10.1002/alz.13763  

   Ross, Heather M; Dzenga, Primrose; Myers, Martha; Squires, Alisa; Duncan, Stephanie; Caradine, Jamilyn; Scharf, Phillip; Bowman, Diana M (May 2024, Alzheimer's & Dementia)

   Abstract INTRODUCTIONOlder adults represent the fastest growing segment of the homeless community. Little is known about the prevalence of dementia and mild cognitive impairment (MCI) in this population. METHODSDementia and MCI screening using the Montreal Cognitive Assessment (MoCA) was incorporated into the standard senior evaluation for adult clients aged ≥ 55 in a large emergency homeless shelter. RESULTSIn a 6‐week period, 104 of 112 (92.9%) assessments were positive for dementia or MCI using a standard cutoff of 26, and 81 (72.3%) were positive using a conservative cutoff of 23. There was no significant difference in MoCA scores based on sex or education level, and no significant correlation between age and MoCA score. DISCUSSIONOlder adults experiencing homelessness may have a high likelihood of dementia or MCI. Routine MoCA screening in older adults experiencing homelessness is feasible and can help to identify services needed to successfully exit homelessness. 

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5. Deep multiview learning to identify imaging-driven subtypes in mild cognitive impairment

   https://doi.org/10.1186/s12859-022-04946-x  

   Feng, Yixue; Kim, Mansu; Yao, Xiaohui; Liu, Kefei; Long, Qi; Shen, Li; for the Alzheimer’s Disease Neuroimaging Initiative (September 2022, BMC Bioinformatics)

   Abstract BackgroundIn Alzheimer’s Diseases (AD) research, multimodal imaging analysis can unveil complementary information from multiple imaging modalities and further our understanding of the disease. One application is to discover disease subtypes using unsupervised clustering. However, existing clustering methods are often applied to input features directly, and could suffer from the curse of dimensionality with high-dimensional multimodal data. The purpose of our study is to identify multimodal imaging-driven subtypes in Mild Cognitive Impairment (MCI) participants using a multiview learning framework based on Deep Generalized Canonical Correlation Analysis (DGCCA), to learn shared latent representation with low dimensions from 3 neuroimaging modalities. ResultsDGCCA applies non-linear transformation to input views using neural networks and is able to learn correlated embeddings with low dimensions that capture more variance than its linear counterpart, generalized CCA (GCCA). We designed experiments to compare DGCCA embeddings with single modality features and GCCA embeddings by generating 2 subtypes from each feature set using unsupervised clustering. In our validation studies, we found that amyloid PET imaging has the most discriminative features compared with structural MRI and FDG PET which DGCCA learns from but not GCCA. DGCCA subtypes show differential measures in 5 cognitive assessments, 6 brain volume measures, and conversion to AD patterns. In addition, DGCCA MCI subtypes confirmed AD genetic markers with strong signals that existing late MCI group did not identify. ConclusionOverall, DGCCA is able to learn effective low dimensional embeddings from multimodal data by learning non-linear projections. MCI subtypes generated from DGCCA embeddings are different from existing early and late MCI groups and show most similarity with those identified by amyloid PET features. In our validation studies, DGCCA subtypes show distinct patterns in cognitive measures, brain volumes, and are able to identify AD genetic markers. These findings indicate the promise of the imaging-driven subtypes and their power in revealing disease structures beyond early and late stage MCI. 

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