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      Episodic-Memory Performance in Machine Learning Modeling for Predicting Cognitive Health Status Classification

      research-article
      a , * , b , c , d , b , e
      Journal of Alzheimer's Disease
      IOS Press
      Aging, Alzheimer’s disease, dementia, mass screening

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          Abstract

          Background:

          Memory dysfunction is characteristic of aging and often attributed to Alzheimer’s disease (AD). An easily administered tool for preliminary assessment of memory function and early AD detection would be integral in improving patient management.

          Objective:

          Our primary aim was to utilize machine learning in determining initial viable models to serve as complementary instruments in demonstrating efficacy of the MemTrax online Continuous Recognition Tasks (M-CRT) test for episodic-memory screening and assessing cognitive impairment.

          Methods:

          We used an existing dataset subset ( n = 18,395) of demographic information, general health screening questions (addressing memory, sleep quality, medications, and medical conditions affecting thinking), and test results from a convenience sample of adults who took the M-CRT test. M-CRT performance and participant features were used as independent attributes: true positive/negative, percent responses/correct, response time, age, sex, and recent alcohol consumption. For predictive modeling, we used demographic information and test scores to predict binary classification of the health-related questions (yes/no) and general health status (healthy/unhealthy), based on the screening questions.

          Results:

          ANOVA revealed significant differences among HealthQScore groups for response time true positive ( p = 0.000) and true positive ( p = 0.020), but none for true negative ( p = 0.0551). Both % responses and % correct had significant differences ( p = 0.026 and p = 0.037, respectively). Logistic regression was generally the top-performing learner with moderately robust prediction performance (AUC) for HealthQScore (0.648–0.680) and selected general health questions (0.713–0.769).

          Conclusion:

          Our novel application of supervised machine learning and predictive modeling helps to demonstrate and validate cross-sectional utility of MemTrax in assessing early-stage cognitive impairment and general screening for AD.

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          Most cited references19

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          Experimental perspectives on learning from imbalanced data

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            Modeling the time-course of Alzheimer dementia.

            Alzheimer's disease (AD) progresses from a preclinical period, through a middle phase of cognitive deterioration, to a late, profound state. The temporal progression of disability can be modeled with a horologic (time-based) function using "time-index" (TI) intervals (day- or year-units) to quantify an individual's disability across multiple cognitive and functional domains relative to a reference AD population. Clinicians and researchers can use TI quantification to assess dementia severity and initial therapy benefits. Rate of progression and confidence intervals require at least two successive measurements. Rate of progression measures can be used to support diagnosis and to investigate disease-course-modifying therapies.
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              Alzheimer patient evaluation and the mini-mental state: item characteristic curve analysis.

              To develop a tool for precisely assessing dementia severity, items should be selected according to their relationship to the overall progression of the disease. Using an item characteristic curve analysis (ICC), items were examined from the Folstein Mini-Mental State Exam (MMSE), a useful clinical tool for evaluating dementia. MMSE data were available for 86 patients who met DSM-III criteria for primary degenerative dementia -- possible or probable Alzheimer's disease (AD). A logistic regression analysis of the probability of correct performance on an item, given the total MMSE score, yielded statistics for difficulty and discrimination. These statistics were interpreted respectively as indicators of the point in the progression of the illness at which the mental function tested by that item is lost and the rapidity of that loss. The data indicated a systematic progression of the development of symptoms in AD related to decline of memory function. Temporal orientation was lost before spatial and object orientation, and recollection of words was lost before ability to repeat them. ICC can help to delineate the loss of mental functions during the course of AD.
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                Author and article information

                Journal
                J Alzheimers Dis
                J. Alzheimers Dis
                JAD
                Journal of Alzheimer's Disease
                IOS Press (Nieuwe Hemweg 6B, 1013 BG Amsterdam, The Netherlands )
                1387-2877
                1875-8908
                03 June 2019
                02 July 2019
                2019
                : 70
                : 1
                : 277-286
                Affiliations
                [a ]SIVOTEC Analytics, Boca Raton, FL, USA
                [b ]Department of Computer and Electrical Engineering and Computer Science, Florida Atlantic University , Boca Raton, FL, USA
                [c ]HAPPYneuron, S.A.S., Lyon, France
                [d ]MemTrax, LLC., Redwood City, CA, USA
                [e ]War-Related Illness and Injury Study Center, VA Palo Alto Health Care System and Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine , Palo Alto, CA, USA
                Author notes
                [* ]Correspondence to: Michael F. Bergeron, PhD, FACSM, SIVOTEC Analytics, Boca Raton Innovation Campus, 4800 T-Rex Avenue, Suite 315, Boca Raton, FL 33431, USA. E-mail: mbergeron@ 123456sivotecanalytics.com .
                Article
                JAD190165
                10.3233/JAD-190165
                6700609
                31177223
                574d68d3-1d32-40b5-a771-1d8282edc45b
                © 2019 – IOS Press and the authors. All rights reserved

                This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                Research Article

                aging,alzheimer’s disease,dementia,mass screening
                aging, alzheimer’s disease, dementia, mass screening

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