“…Two financial management abilities – managing taxes and paying bills – are also known FAQ items which decline early in the course of dementing disorders 16-19 . For predicting conversion to MCI, aMCI, and naMCI, useful predictor variables included items from the UPDRS, history of falls, presence of tremor (captured in UPDRS), bradykinesia, hypomimia, and speech changes.…”
Background
Clinical trials increasingly aim to retard disease progression during pre-symptomatic phases of Mild Cognitive Impairment (MCI) and thus recruiting study participants at high risk for developing MCI is critical for cost-effective prevention trials. However, accurately identifying those who are destined to develop MCI is difficult. Collecting biomarkers is often expensive.
Methods
We used only non-invasive clinical variables collected in the National Alzheimer’s Coordinating Center (NACC) Uniform Data Sets version 2.0 and applied machine learning techniques to build a low-cost and accurate Mild Cognitive Impairment (MCI) conversion prediction calculator. Cross-validation and bootstrap were used to select as few variables as possible accurately predicting MCI conversion within 4 years.
Results
31,872 unique subjects, 748 clinical variables and additional 128 derived variables in NACC data sets were used. 15 non-invasive clinical variables are identified for predicting MCI/aMCI/naMCI converters, respectively. Over 75% Receiver Operating Characteristic Area Under the Curves (ROC AUC) was achieved. By bootstrap we created a simple spreadsheet calculator which estimates the probability of developing MCI within 4 years with a 95% confidence interval.
Conclusions
We achieved reasonably high prediction accuracy using only clinical variables. The approach used here could be useful for study enrichment in pre-clinical trials where enrolling participants at risk of cognitive decline is critical for proving study efficacy, and also for developing a shorter assessment battery.
“…Two financial management abilities – managing taxes and paying bills – are also known FAQ items which decline early in the course of dementing disorders 16-19 . For predicting conversion to MCI, aMCI, and naMCI, useful predictor variables included items from the UPDRS, history of falls, presence of tremor (captured in UPDRS), bradykinesia, hypomimia, and speech changes.…”
Background
Clinical trials increasingly aim to retard disease progression during pre-symptomatic phases of Mild Cognitive Impairment (MCI) and thus recruiting study participants at high risk for developing MCI is critical for cost-effective prevention trials. However, accurately identifying those who are destined to develop MCI is difficult. Collecting biomarkers is often expensive.
Methods
We used only non-invasive clinical variables collected in the National Alzheimer’s Coordinating Center (NACC) Uniform Data Sets version 2.0 and applied machine learning techniques to build a low-cost and accurate Mild Cognitive Impairment (MCI) conversion prediction calculator. Cross-validation and bootstrap were used to select as few variables as possible accurately predicting MCI conversion within 4 years.
Results
31,872 unique subjects, 748 clinical variables and additional 128 derived variables in NACC data sets were used. 15 non-invasive clinical variables are identified for predicting MCI/aMCI/naMCI converters, respectively. Over 75% Receiver Operating Characteristic Area Under the Curves (ROC AUC) was achieved. By bootstrap we created a simple spreadsheet calculator which estimates the probability of developing MCI within 4 years with a 95% confidence interval.
Conclusions
We achieved reasonably high prediction accuracy using only clinical variables. The approach used here could be useful for study enrichment in pre-clinical trials where enrolling participants at risk of cognitive decline is critical for proving study efficacy, and also for developing a shorter assessment battery.
“…For example, consumers have a right to make decisions about how and where they spend and invest their money, even if these choices are not in their best interests. So although firms have relationship management and risk management reasons to intervene when fraud is suspected, they must also be cautious not to infringe on their clients' autonomy (Lichtenberg 2016;Lock 2016). This means they must attempt to differentiate when losses are due to financial victimization versus when they result from poor consumer decision making in risky financial markets.…”
Section: Background and Significancementioning
confidence: 99%
“…To limit opportunities for fraud and financial abuse, Lichtenberg (2016) has recommended proactive estate planning between financial service professionals and their customers. Some firms reported using the educational outreach materials developed by their companies as conversation starters to encourage clients to think about whom they would appoint as authorized representatives should they be unable to make financial decisions independently.…”
Section: Preventing Exploitation Through Early Financial Planningmentioning
Elder financial victimization is a growing problem facing older Americans. As the conduits of financial transactions, financial firms are positioned to stop losses at their source. Representatives at small and large firms were interviewed to describe their financial exploitation training and prevention programs, their detection and response protocols, and how they balance the goals of client protection with the client's right to autonomy and privacy in financial decision-making. Representatives from regulatory agencies were interviewed to describe the interventions firms are authorized to engage in, the legal barriers they face, and recent rule change proposals that may overcome some of these barriers.
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