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The Journal of Alzheimer’s Disease is an international multidisciplinary journal to facilitate progress in understanding the etiology, pathogenesis, epidemiology, genetics, behavior, treatment and psychology of Alzheimer’s disease.
The journal publishes research reports, reviews, short communications, book reviews, and letters-to-the-editor. The journal is dedicated to providing an open forum for original research that will expedite our fundamental understanding of Alzheimer’s disease.
Authors: Mathew, Sunu | WuDunn, Darrell | Mackay, Devin D. | Vosmeier, Aaron | Tallman, Eileen F. | Deardorff, Rachael | Harris, Alon | Farlow, Martin R. | Brosch, Jared R. | Gao, Sujuan | Apostolova, Liana G. | Saykin, Andrew J. | Risacher, Shannon L.
Article Type: Research Article
Abstract: Background: The eye has been considered a ‘window to the brain,’ and several neurological diseases including neurodegenerative conditions like Alzheimer’s disease (AD) also show changes in the retina. Objective: To investigate retinal nerve fiber layer (RNFL) thickness and its association with brain volume via magnetic resonance imaging (MRI) in older adults with subjective or objective cognitive decline. Methods: 75 participants underwent ophthalmological and neurological evaluation including optical coherence tomography and MRI (28 cognitively normal subjects, 26 with subjective cognitive decline, 17 patients diagnosed with mild cognitive impairment, and 4 with AD). Differences in demographics, thickness of …RNFL, and brain volume were assessed using ANCOVA, while partial Pearson correlations, covaried for age and sex, were used to compare thickness of the peripapillary RNFL with brain volumes, with p < 0.05 considered statistically significant. Results: Mean RNFL thickness was significantly correlated with brain volumes, including global volume (right eye r = 0.235 p = 0.046, left eye r = 0.244, p = 0.037), temporal lobe (right eye r = 0.242 p = 0.039, left eye r = 0.290, p = 0.013), hippocampal (right eye r = 0.320 p = 0.005, left eye r = 0.306, p = 0.008), amygdala (left eye r = 0.332, p = 0.004), and occipital lobe (right eye r = 0.264 p = 0.024) volumes. Conclusion: RNFL thickness in both eyes was positively associated with brain volumes in subjects with subjective and objective cognitive decline. The RNFL, however, did not correlate with the disease, but the small sample number makes it important to conduct larger studies. RNFL thickness may be a useful non-invasive and inexpensive tool for detection of brain neurodegeneration and may assist with diagnosis and monitoring of progression and treatment in AD. Show more
Keywords: Alzheimer’s disease, brain volume, MRI, neurodegeneration, optical coherence tomography, retinal nerve fiber layer
DOI: 10.3233/JAD-210533
Citation: Journal of Alzheimer's Disease, vol. 91, no. 2, pp. 743-752, 2023
Authors: Chandler, Julie | Kubisiak, Joanna
Article Type: Research Article
Abstract: Background: The high burden of dementia and Alzheimer’s disease (AD) increases substantially as disease progresses. Characterizing early patterns of health care utilization among patients who develop cognitive impairment may deepen our understanding of early disease trajectory and potentially facilitate timely diagnosis and management. Objective: Describe clinical characteristics, healthcare utilization, and costs in early-stage dementia by disease severity and amyloid-β status before enrollment in an observational study (GERAS-US). Methods: Consented patients’ GERAS-US data were linked to available five-years of Medicare claims history before GERAS-US enrollment. Clinical characteristics, comorbidity, and pre-/post-diagnosis healthcare use and costs were assessed. Continuous …and categorical variables were compared between severity and amyloid-status cohorts using t -test and Chi-square statistics; linear regression models were used to compare cost and utilization measures after adjusting for differences in patients’ observation time. Relative likelihood of observed diagnoses, comorbidity, and prescription drug use among cohorts were presented as OR and 90% confidence interval (CI). Results: Of 174 patients clinically diagnosed with early dementia (mild cognitive impairment (MCI): 101; mild dementia (MILD): 73), 55% were amyloid-positive. Memory loss was more likely in MILD versus MCI (OR:1.85, 90% CI 1.10–3.09) and in amyloid-positive versus amyloid-negative cohorts (OR:1.98, 90% CI 1.19–3.29). Mean annual healthcare costs after cognitive impairment/dementia diagnosis were significantly higher for MILD versus MCI ($1191 versus $712, p = 0.067) and amyloid-negative versus amyloid-positive ($1281 versus $701, p = 0.034). Diabetes was more prevalent in MILD and amyloid-negative cohorts. Conclusion: Comorbidity and economic burden increased in earliest stages of MCI and MILD and were higher in patients who were amyloid-negative. Show more
Keywords: Amyloid, burden of illness, comorbidity, dementia, economic burden, health care utilization, mild cognitive impairment
DOI: 10.3233/JAD-220415
Citation: Journal of Alzheimer's Disease, vol. 91, no. 2, pp. 753-765, 2023
Authors: Sun, Jiaojiao | Zhao, Xingfu | Zhou, Jianbang | Dang, Xinghong | Zhu, Shenglong | Liu, Liang | Zhou, Zhenhe
Article Type: Research Article
Abstract: Background: Resting-state function MRI (rs-fMRI) research on successful aging can provide insight into the mechanism of aging with a different perspective from aging-related disease. Objective: rs-fMRI research was used to analyze the brain function characteristics of successful aging. Methods: A total of 47 usual aging individuals and 26 successful aging (SA) individuals underwent rs-fMRI scans and neuropsychological tests. Volume-based rs-fMRI data analysis was performed with DPASF to obtain ALFF, ReHo, DC, and VMHC. Results: The SA group showed increased ALFF in right opercular part of inferior frontal gyrus (Frontal_Inf_Oper_R) and right supramarginal gyrus; increased …ReHo in right middle temporal pole gyrus and decreased ReHo in left superior frontal gyrus and middle occipital gyrus; increased DC in right medial orbitofrontal gyrus and pulvinar part of thalamus; decreased DC in left fusiform gyrus and right medial frontal gyrus; increased VMHC in right medial orbitofrontal gyrus; and decreased VMHC in the right superior temporal gyrus, right and left middle temporal gyrus, right and left triangular part of inferior frontal gyrus. ALFF in Frontal_Inf_Oper_R were found to be significantly correlated with MMSE scores (r = 0.301, p = 0.014) and ages (r = –0.264, p = 0.032) in all subjects, which could be used to distinguish the SA (AUC = 0.733, 95% CI: 0.604–0.863) by ROC analysis. Conclusion: The brain regions with altered fMRI characteristics in SA group were concentrated in frontal (6 brain regions) and temporal (4 brain regions) lobes. ALFF in Frontal_Inf_Oper_R was significantly correlated to cognitive function and ages, which might be used to distinguish the SA. Show more
Keywords: Amplitude of low frequency fluctuations, degree centrality, regional homogeneity, resting-state fMRI, successful aging, voxel-mirrored homotopic connectivity
DOI: 10.3233/JAD-220780
Citation: Journal of Alzheimer's Disease, vol. 91, no. 2, pp. 767-778, 2023
Authors: Iban-Arias, Ruth | Trageser, Kyle J. | Yang, Eun-Jeong | Griggs, Elizabeth | Radu, Aurelian | Naughton, Sean | Al Rahim, Md | Tatsunori, Oguchi | Raval, Urdhva | Palmieri, Joshua | Huang, Zerlina | Chen, Lung-Chi | Pasinetti, Giulio Maria
Article Type: Research Article
Abstract: Background: The terrorist attacks on September 11, 2001, on the World Trade Center (WTC) led to intense fires and a massive dense cloud of toxic gases and suspended pulverized debris. In the subsequent years, following the attack and cleanup efforts, a cluster of chronic health conditions emerged among First Responders (FR) who were at Ground Zero for prolonged periods and were repeatedly exposed to high levels of WTC particulate matter (WTCPM). Among those are neurological complications which may increase the risk for the development of Alzheimer’s disease (AD) later in life. Objective: We hypothesize that WTCPM dust exposure …affects the immune cross-talking between the periphery and central nervous systems that may induce brain permeability ultimately promoting AD-type phenotype. Methods: 5XFAD and wild-type mice were intranasally administered with WTCPM dust collected at Ground Zero within 72 h after the attacks. Y-maze assay and novel object recognition behavioral tests were performed for working memory deficits and learning and recognition memory, respectively. Transcriptomic analysis in the blood and hippocampus was performed and confirmed by RT qPCR. Results: Mice exposed to WTCPM dust exhibited a significant impairment in spatial and recognition short and long-term memory. Furthermore, the transcriptomic analysis in the hippocampal formation and blood revealed significant changes in genes related to immune-inflammatory responses, and blood-brain barrier disruption. Conclusion: These studies suggest a putative peripheral-brain immune inflammatory cross-talking that may potentiate cognitive decline, identifying for the first time key steps which may be therapeutically targetable in future studies in WTC FR. Show more
Keywords: Blood-brain barrier, Claudin-5, cognitive decline, MMP-9, neuroinflammation, World Trade Center particulate matter
DOI: 10.3233/JAD-221046
Citation: Journal of Alzheimer's Disease, vol. 91, no. 2, pp. 779-794, 2023
Authors: Cheng, Zhao-Zhao | Gao, Feng | Lv, Xin-Yi | Wang, Qiong | Wu, Yan | Sun, Bao-Liang | Shen, Yong
Article Type: Research Article
Abstract: Background: Cerebral small vessel disease (CSVD), which comprises the typical features of white matter hyperintensity (WMH) and Vichor-Robin spaces (VRSs) in the brain, is one of the leading causes of aging-related cognitive decline and, ultimately, contributes to the occurrence of dementia, including Alzheimer’s disease (AD). Objective: To investigate whether CSVD imaging markers modify the pathological processes of AD and whether these markers improve AD diagnosis. Methods: 208 participants were enrolled in the China Aging and Neurodegenerative Initiative (CANDI). Fluid AD biomarkers were detected using a single-molecule array, and cerebral small vessel dysfunction was determined using magnetic …resonance imaging. Results: WMH contributed to AD pathology only within the NC and MCI groups (CDR ≤0.5), whereas VRSs had no effect on AD pathology. The associations between AD biomarkers and cognitive mental status were consistent with the presence of CSVD pathology. That is, within individuals without CSVD pathology, the MMSE scores were correlated with AD fluid biomarkers, except for plasma Aβ42 and Aβ40 . Increased plasma p-Tau levels were associated with worse cognitive performance in individuals with WMH (β= –0.465, p = 0.0016) or VRSs (β= –0.352, p = 0.0257) pathology. Plasma AD biomarkers combined with CSVD markers showed high accuracy in diagnosing dementia. Conclusion: Findings from this cross-sectional cohort study support the notion that CSVD is a risk factor for dementia and highlights that vascular pathology can promote AD biomarker levels, especially in the early course of the disease. Moreover, our results suggest that adding a vascular category to the ATN framework improves the diagnostic accuracy of AD. Show more
Keywords: Alzheimer’s disease, cerebrovascular disease, Clinical Dementia Rating, Vichor-Robin space, white matter hyperintensity
DOI: 10.3233/JAD-220872
Citation: Journal of Alzheimer's Disease, vol. 91, no. 2, pp. 795-804, 2023
Authors: Noguchi-Shinohara, Moeko | Hamaguchi, Tsuyoshi | Sakai, Kenji | Komatsu, Junji | Iwasa, Kazuo | Horimoto, Mai | Nakamura, Hiroyuki | Yamada, Masahito | Ono, Kenjiro
Article Type: Research Article
Abstract: Background: Previous in vitro and in vivo studies on Alzheimer’s disease (AD) models have reported that rosmarinic acid (RA) can inhibit the formation of amyloid-β fibrils as well as the oligomerization and deposition of amyloid-β protein. Melissa officinalis (M. officinalis ) extract containing 500 mg of RA is tolerable and safe in healthy individuals and patients with mild AD dementia. Objective: This randomized placebo-controlled double-blind trial aimed to assess the effects of M. officinalis extract on cognition in older adults without dementia. Methods: This study included individuals who were diagnosed with subjective or …mild cognitive impairment (n = 323). The trial involved M. officinalis extract supplementation (500 mg of RA per day) period of 96 weeks followed by a washout period of 24 weeks. The primary endpoint was the Alzheimer’s Disease Assessment Scale-cognitive subscale score, and the secondary endpoints were other cognitive measure results as well as safety and tolerability. Results: There were no significant differences in cognitive measures between the placebo and M. officinalis groups from baseline to 96 weeks. However, based on the analysis of Clinical Dementia Rating Sum of Boxes scores in participants without hypertension, the score was found to be increased by 0.006 and decreased by 0.085 in the M. officinalis and placebo groups, respectively; this difference was statistically significant (p = 0.036). Furthermore, there were no differences in vital signs, physical and neurological measures, or hippocampal volume between the two groups. Conclusion: These results indicate that M. officinalis extract may help prevent cognitive decline in older adults without hypertension. Show more
Keywords: Cognitive decline, efficacy, Melissa officinalis extract, prevention, rosmarinic acid
DOI: 10.3233/JAD-220953
Citation: Journal of Alzheimer's Disease, vol. 91, no. 2, pp. 805-814, 2023
Authors: Luo, Yuting | Lin, Rong | Yan, Yuanjiao | Su, Jiawei | Lin, Shengmei | Ma, Mingping | Li, Hong
Article Type: Research Article
Abstract: Background: Mild cognitive impairment (MCI) is a stage of cognitive ability loss with intact activities of daily living and an increased risk for the development of dementia. Objective: This study evaluated the intervention effect of remote expressive arts program (rEAP) on cognitive function in older adults with MCI and investigated the underlying neurobiological mechanisms. Methods: We assigned 73 older MCI patients to receive rEAP or health education (HE), who underwent neuropsychological evaluation and resting-state functional magnetic resonance imaging before and after treatment. Neuropsychological scores were analyzed using SPSS software, and regional homogeneity (ReHo) values and seed-based …functional connectivity (FC) were analyzed using Matlab software. Results: The rEAP group showed more significant improvements in cognitive function than the HE group. rEAP affected spontaneous brain activity and brain networks. The ReHo values in the right anterior cingulate/paracingulate cortex and the left dorsolateral superior frontal gyrus significantly increased and decreased, respectively, in the rEAP and HE groups. Further, ReHo value changes were significantly associated with the corresponding neuropsychological test score changes in the rEAP group. Moreover, the rEAP group showed decreased FC between the posterior cingulate cortex and the right middle temporal gyrus and increased FC between the ventromedial prefrontal cortex and left angular gyrus. Conclusion: The 12-week rEAP improved cognitive function in MCI patients. Additionally, the alterations of spontaneous brain network connections and activity helped improve and maintain cognitive function in MCI patients. Show more
Keywords: Aged, art therapy, cognitive dysfunction, magnetic resonance imaging, telemedicine
DOI: 10.3233/JAD-215685
Citation: Journal of Alzheimer's Disease, vol. 91, no. 2, pp. 815-831, 2023
Authors: Heneghan, Amy | Deng, Feng | Wells, Katie | Ritchie, Karen | Muniz-Terrera, Graciela | Ritchie, Craig W. | Lawlor, Brian | Naci, Lorina
Article Type: Research Article
Abstract: Background: It is now acknowledged that Alzheimer’s disease (AD) processes are present decades before the onset of clinical symptoms, but it remains unknown whether lifestyle factors can protect against these early AD processes in mid-life. Objective: We asked whether modifiable lifestyle activities impact cognition in middle-aged individuals who are cognitively healthy, but at risk for late life AD. Participants (40–59 years) completed cognitive and clinical assessments at baseline (N = 206) and two years follow-up (N = 174). Methods: Mid-life activities were measured with the Lifetime of Experiences Questionnaire. We assessed the impact of lifestyle activities, known risk factors for …sporadic late-onset AD (Apolipoprotein E ɛ4 allele status, family history of dementia, and the Cardiovascular Risk Factors Aging and Dementia score), and their interactions on cognition. Results: More frequent engagement in physically, socially, and intellectually stimulating activities was associated with better cognition (verbal, spatial, and relational memory), at baseline and follow-up. Critically, more frequent engagement in these activities was associated with stronger cognition (verbal and visuospatial functions, and conjunctive short-term memory binding) in individuals with family history of dementia. Impaired visuospatial function is one of the earliest cognitive deficits in AD and has previously associated with increased AD risk in this cohort. Additionally, conjunctive memory functions have been found impaired in the pre-symptomatic stages of AD. Conclusion: These findings suggest that modifiable lifestyle activities offset cognitive decrements due to AD risk in mid-life and support the targeting of modifiable lifestyle activities for the prevention of AD. Show more
Keywords: Alzheimer’s disease, cognition, cognitively healthy, lifestyle factors, mid-life, risk factors
DOI: 10.3233/JAD-220267
Citation: Journal of Alzheimer's Disease, vol. 91, no. 2, pp. 833-846, 2023
Authors: Calderón-Garcidueñas, Lilian | Kulesza, Randy | Greenough, Glen P. | García-Rojas, Edgar | Revueltas-Ficachi, Paula | Rico-Villanueva, Adriana | Flores-Vázquez, Jorge Orlando | Brito-Aguilar, Rafael | Ramírez-Sánchez, Silvia | Vacaseydel-Aceves, Nora | Cortes-Flores, Ana Paulina | Mansour, Yusra | Torres-Jardón, Ricardo | Villarreal-Ríos, Rodolfo | Koseoglu, Emel | Stommel, Elijah W. | Mukherjee, Partha S.
Article Type: Research Article
Abstract: Background: Quadruple aberrant hyperphosphorylated tau, amyloid-β, α-synuclein, and TDP-43 pathology had been documented in 202/203 forensic autopsies in Metropolitan Mexico City ≤40-year-olds with high exposures to ultrafine particulate matter and engineered nanoparticles. Cognition deficits, gait, equilibrium abnormalities, and MRI frontal, temporal, caudate, and cerebellar atrophy are documented in young adults. Objective: This study aimed to identify an association between falls, probable Rapid Eye Movement Sleep Behavior Disorder (pRBD), restless leg syndrome (RLS), and insomnia in 2,466 Mexican, college-educated volunteers (32.5±12.4 years). Methods: The anonymous, online study applied the pRBD and RLS Single-Questions and self-reported night-time sleep …duration, excessive daytime sleepiness, insomnia, and falls. Results: Fall risk was strongly associated with pRBD and RLS. Subjects who fell at least once in the last year have an OR = 1.8137 [1.5352, 2.1426 ] of answering yes to pRBD and/or RLS questions, documented in 29% and 24% of volunteers, respectively. Subjects fell mostly outdoors (12:01 pm to 6:00 pm), 43% complained of early wake up hours, and 35% complained of sleep onset insomnia (EOI). EOI individuals have an OR of 2.5971 [2.1408, 3.1506 ] of answering yes to the RLS question. Conclusion: There is a robust association between falls, pRBD, and RLS, strongly suggesting misfolded proteinopathies involving critical brainstem arousal and motor hubs might play a crucial role. Nanoparticles are likely a significant risk for falls, sleep disorders, insomnia, and neurodegenerative lethal diseases, thus characterizing air particulate pollutants’ chemical composition, emission sources, and cumulative exposure concentrations are strongly recommended. Show more
Keywords: Air pollution, Alzheimer’s disease, falls, Mexico City young urbanites, nanoparticles, PM2.5 , possible REM sleep behavior disorder, quadruple proteinopathies, restless leg syndrome, TDP-43 proteinopathies
DOI: 10.3233/JAD-220850
Citation: Journal of Alzheimer's Disease, vol. 91, no. 2, pp. 847-862, 2023
Authors: Liu, Yajing | Zeng, Zhenhua | Huang, Shuyun | Shang, Pan | Lv, Zeping | Wang, Yukai | Luo, Jiali | Chen, Jinjuan | Shi, Jian | Huang, Qiaobing | Xie, Haiqun | Chen, Zhongqing
Article Type: Research Article
Abstract: Background: Amnestic mild cognitive impairment (aMCI) is regarded as a transitional state of Alzheimer’s disease, with working memory (WM) impairment. Objective: To investigate the brain activity in aMCI patients during WM tasks with the functional near-infrared spectroscopy (fNIRS) technique, as well as explore the association between brain activity and cognitive function in multiple domains. Methods: This study is a case-control study of 54 aMCI patients and 33 cognitively healthy elderly (NC). All participants underwent neuropsychological assessments. fNIRS was applied to examine the brain activation during the WM task. Multivariable linear regression analysis was applied to evaluate …associations between brain activation and cognitive function in multiple domains. Results: Compared to NC subjects, aMCI patients had lower activation in the bilateral prefrontal, parietal, and occipital cortex during the WM task. Additionally, activation in the left prefrontal, bilateral parietal, and occipital cortex during the encoding and maintenance phase was positively associated with memory function. During memory retrieval, higher activity in the left prefrontal, parietal, and occipital cortex were correlated with higher memory scores. Besides, a positive association also formed between attention function and the activation in the left prefrontal, parietal, and occipital cortex during the WM task. Conclusion: These findings demonstrated that reduced activation in the prefrontal, parietal and occipital cortex during WM might reflect the risk of cognitive impairment, especially memory and attention function in aMCI patients. Given the brain activation visualization, fNIRS may be a convenient and alternative tool for screening the risk of Alzheimer’s disease. Show more
Keywords: Amnestic mild cognitive impairment, brain activation, cognition, functional near-infrared spectroscopy, working memory
DOI: 10.3233/JAD-220815
Citation: Journal of Alzheimer's Disease, vol. 91, no. 2, pp. 863-875, 2023
Authors: Xu, Ling-Zhi | Li, Bing-Qiu | Li, Fang-Yu | Li, Ying | Qin, Wei | Zhao, Yu | Jia, Jian-Ping
Article Type: Research Article
Abstract: Background: Alzheimer’s disease (AD) is the most common form of neurodegenerative dementia among the elderly. Excitotoxicity has been implicated as playing a dominant role in AD, especially related to the hyperactivation of excitatory neurons. Death-associated protein kinase 1 (DAPK1) is a calcium/calmodulin-dependent kinase and involved in the pathogenesis of AD, but the roles and mechanisms of DAPK1 in excitotoxicity in AD are still uncertain. Objective: We mainly explored the underlying mechanisms of DAPK1 involved in the excitotoxicity of AD and its clinical relevance. Methods: Differentiated SH-SY5Y human neuroblastoma cells, PS1 V97 L transgenic mice, and human plasma …samples were used. Protein expression was assayed by immunoblotting, and intracellular calcium and neuronal damage were analyzed by flow cytometry. Plasma DAPK1 was measured by ELISA. Results: We found that DAPK1 was activated after amyloid-β oligomers (AβOs) exposure in differentiated SH-SY5Y cells. Besides, we found the phosphorylation of GluN2B subunit at Ser1303 was increased, which contributing to excitotoxicity and Ca2+ overload in SH-SY5Y cells. Inhibiting DAPK1 activity, knockdown of DAPK1 expression, and antagonizing GluN2B subunits could effectively prevent AβOs-induced activation of GluN2B subunit, Ca2+ overload, and neuronal apoptosis. Additionally, we found that DAPK1 was elevated in the brain of AD transgenic mouse and in the plasma of AD patients. Conclusion: Our finding will help to understand the mechanism of DAPK1 in the excitotoxicity in AD and provide a reference for the diagnosis and therapy of AD. Show more
Keywords: Alzheimer’s disease, amyloid-β oligomers, death-associated protein kinase 1, excitotoxicity, GluN2B, N-methyl-D-aspartic acid receptor
DOI: 10.3233/JAD-220747
Citation: Journal of Alzheimer's Disease, vol. 91, no. 2, pp. 877-893, 2023
Authors: Kleiman, Michael J. | Ariko, Taylor | Galvin, James E.
Article Type: Research Article
Abstract: Background: The detection of subtle cognitive impairment in a clinical setting is difficult. Because time is a key factor in small clinics and research sites, the brief cognitive assessments that are relied upon often misclassify patients with very mild impairment as normal. Objective: In this study, we seek to identify a parsimonious screening tool in one stage, followed by additional assessments in an optional second stage if additional specificity is desired, tested using a machine learning algorithm capable of being integrated into a clinical decision support system. Methods: The best primary stage incorporated measures of short-term …memory, executive and visuospatial functioning, and self-reported memory and daily living questions, with a total time of 5 minutes. The best secondary stage incorporated a measure of neurobiology as well as additional cognitive assessment and brief informant report questionnaires, totaling 30 minutes including delayed recall. Combined performance was evaluated using 25 sets of models, trained on 1,181 ADNI participants and tested on 127 patients from a memory clinic. Results: The 5-minute primary stage was highly sensitive (96.5%) but lacked specificity (34.1%), with an AUC of 87.5% and diagnostic odds ratio of 14.3. The optional secondary stage increased specificity to 58.6%, resulting in an overall AUC of 89.7% using the best model combination of logistic regression and gradient-boosted machine. Conclusion: The primary stage is brief and effective at screening, with the optional two-stage technique further increasing specificity. The hierarchical two-stage technique exhibited similar accuracy but with reduced costs compared to the more common single-stage paradigm. Show more
Keywords: Alzheimer’s disease, clinical decision support, machine learning, mild cognitive impairment, neuropsychological assessment
DOI: 10.3233/JAD-220891
Citation: Journal of Alzheimer's Disease, vol. 91, no. 2, pp. 895-909, 2023
Article Type: Correction
DOI: 10.3233/JAD-229020
Citation: Journal of Alzheimer's Disease, vol. 91, no. 2, pp. 911-911, 2023
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