School of Public Health, Xiamen University, Xiamen, Fujian, China.
Key Laboratory of Health Technology Assessment of Fujian Province, Xiamen University, Xiamen, Fujian, China.
Age Ageing. 2023 Sep 1;52(9). doi: 10.1093/ageing/afad182.
Mild cognitive impairment (MCI) is the early stage of AD, and about 10-12% of MCI patients will progress to AD every year. At present, there are no effective markers for the early diagnosis of whether MCI patients will progress to AD. This study aimed to develop machine learning-based models for predicting the progression from MCI to AD within 3 years, to assist in screening and prevention of high-risk populations.
Data were collected from the Alzheimer's Disease Neuroimaging Initiative, a representative sample of cognitive impairment population. Machine learning models were applied to predict the progression from MCI to AD, using demographic, neuropsychological test and MRI-related biomarkers. Data were divided into training (56%), validation (14%) and test sets (30%). AUC (area under ROC curve) was used as the main evaluation metric. Key predictors were ranked utilising their importance.
The AdaBoost model based on logistic regression achieved the best performance (AUC: 0.98) in 0-6 month prediction. Scores from the Functional Activities Questionnaire, Modified Preclinical Alzheimer Cognitive Composite with Trails test and ADAS11 (Unweighted sum of 11 items from The Alzheimer's Disease Assessment Scale-Cognitive Subscale) were key predictors.
Through machine learning, neuropsychological tests and MRI-related markers could accurately predict the progression from MCI to AD, especially in a short period time. This is of great significance for clinical staff to screen and diagnose AD, and to intervene and treat high-risk MCI patients early.
轻度认知障碍(MCI)是 AD 的早期阶段,约有 10-12%的 MCI 患者每年会发展为 AD。目前,尚无有效的标志物可用于早期诊断 MCI 患者是否会进展为 AD。本研究旨在开发基于机器学习的模型,以预测 MCI 患者在 3 年内向 AD 进展的情况,从而辅助对高危人群进行筛查和预防。
数据来自阿尔茨海默病神经影像学倡议(代表认知障碍人群的样本)。应用机器学习模型,使用人口统计学、神经心理学测试和 MRI 相关生物标志物来预测 MCI 向 AD 的进展。数据分为训练集(56%)、验证集(14%)和测试集(30%)。AUC(ROC 曲线下面积)作为主要评估指标。利用重要性对关键预测因子进行排序。
基于逻辑回归的 AdaBoost 模型在 0-6 个月的预测中表现最佳(AUC:0.98)。功能活动问卷、改良临床前阿尔茨海默病认知综合测试和 ADAS11(阿尔茨海默病评估量表认知子量表的 11 个项目的无权重总和)的分数是关键预测因子。
通过机器学习,神经心理学测试和 MRI 相关标志物可以准确预测 MCI 向 AD 的进展,尤其是在短期内。这对于临床医生筛查和诊断 AD,以及早期干预和治疗高危 MCI 患者具有重要意义。