Exploration of Medicine

Table 4. Predictive performance with 95% CI of candidate models for cognitive resilience.

Predictor_Set^a	Model	AUC	F1	Sensitivity	Specificity	PPV	NPV	Balanced accuracy
Model 1	Logistic	0.561 (0.330, 0.781)	0.444 (0.256, 0.612)	0.312 (0.156, 0.469)	0.700 (0.400, 1.000)	0.769 (0.562, 1.000)	0.241 (0.148, 0.333)	0.506 (0.328, 0.666)
	CART	0.553 (0.344, 0.736)	0.702 (0.561, 0.820)	0.625 (0.469, 0.781)	0.500 (0.200, 0.800)	0.800 (0.690, 0.913)	0.294 (0.125, 0.467)	0.562 (0.381, 0.737)
	Random_Forest	0.567 (0.358, 0.750)	0.841 (0.769, 0.899)	0.906 (0.781, 1.000)	0.200 (0.000, 0.500)	0.784 (0.737, 0.844)	0.400 (0.000, 1.000)	0.553 (0.438, 0.688)
	XGBoost	0.669 (0.442, 0.869)	0.627 (0.455, 0.764)	0.500 (0.313, 0.656)	0.700 (0.400, 1.000)	0.842 (0.706, 1.000)	0.304 (0.190, 0.421)	0.600 (0.434, 0.750)
	LightGBM	0.650 (0.441, 0.845)	0.679 (0.531, 0.813)	0.562 (0.406, 0.719)	0.700 (0.400, 1.000)	0.857 (0.737, 1.000)	0.333 (0.211, 0.474)	0.631 (0.466, 0.781)
Model 2	Logistic	0.575 (0.347, 0.794)	0.615 (0.449, 0.754)	0.500 (0.344, 0.656)	0.600 (0.300, 0.900)	0.800 (0.667, 0.941)	0.273 (0.150, 0.400)	0.550 (0.372, 0.719)
	CART	0.473 (0.291, 0.669)	0.630 (0.468, 0.767)	0.531 (0.344, 0.719)	0.500 (0.200, 0.800)	0.773 (0.650, 0.909)	0.250 (0.111, 0.400)	0.516 (0.347, 0.697)
	Random_Forest	0.588 (0.384, 0.778)	0.865 (0.865, 0.865)	1.000 (1.000, 1.000)	0.000 (0.000, 0.000)	0.762 (0.762, 0.762)	NA^b	0.500 (0.500, 0.500)
	XGBoost	0.617 (0.375, 0.839)	0.679 (0.520, 0.807)	0.562 (0.406, 0.719)	0.700 (0.400, 1.000)	0.857 (0.722, 1.000)	0.333 (0.200, 0.474)	0.631 (0.450, 0.794)
	LightGBM	0.613 (0.378, 0.828)	0.642 (0.478, 0.772)	0.531 (0.345, 0.688)	0.600 (0.300, 0.900)	0.810 (0.682, 0.941)	0.286 (0.150, 0.421)	0.566 (0.384, 0.731)
Model 3a	Logistic	0.553 (0.344, 0.769)	0.654 (0.489, 0.786)	0.531 (0.344, 0.688)	0.700 (0.400, 1.000)	0.850 (0.722, 1.000)	0.318 (0.200, 0.450)	0.616 (0.450, 0.778)
	CART	0.483 (0.294, 0.678)	0.500 (0.318, 0.655)	0.375 (0.219, 0.531)	0.600 (0.300, 0.900)	0.750 (0.571, 0.929)	0.231 (0.125, 0.333)	0.487 (0.319, 0.653)
	Random_Forest	0.647 (0.434, 0.844)	0.849 (0.817, 0.865)	0.969 (0.906, 1.000)	0.000 (0.000, 0.000)	0.756 (0.744, 0.762)	0.000 (0.000, 0.000)	0.484 (0.453, 0.500)
	XGBoost	0.625 (0.412, 0.834)	0.627 (0.459, 0.772)	0.500 (0.344, 0.688)	0.700 (0.400, 1.000)	0.842 (0.706, 1.000)	0.304 (0.190, 0.429)	0.600 (0.431, 0.762)
	LightGBM	0.641 (0.416, 0.844)	0.612 (0.429, 0.764)	0.469 (0.281, 0.656)	0.800 (0.500, 1.000)	0.882 (0.733, 1.000)	0.320 (0.217, 0.429)	0.634 (0.469, 0.766)
Model 3b	Logistic	0.547 (0.338, 0.762)	0.642 (0.478, 0.774)	0.531 (0.344, 0.719)	0.600 (0.300, 0.900)	0.810 (0.682, 0.947)	0.286 (0.158, 0.421)	0.566 (0.388, 0.744)
	CART	0.548 (0.373, 0.703)	0.419 (0.211, 0.596)	0.281 (0.125, 0.438)	0.800 (0.500, 1.000)	0.818 (0.583, 1.000)	0.258 (0.177, 0.333)	0.541 (0.378, 0.684)
	Random_Forest	0.572 (0.369, 0.772)	0.849 (0.817, 0.865)	0.969 (0.906, 1.000)	0.000 (0.000, 0.000)	0.756 (0.744, 0.762)	0.000 (0.000, 0.000)	0.484 (0.453, 0.500)
	XGBoost	0.625 (0.400, 0.831)	0.691 (0.542, 0.814)	0.594 (0.406, 0.750)	0.600 (0.300, 0.900)	0.826 (0.714, 0.952)	0.316 (0.176, 0.471)	0.597 (0.431, 0.766)
	LightGBM	0.694 (0.456, 0.897)	0.654 (0.490, 0.786)	0.531 (0.375, 0.688)	0.700 (0.400, 0.900)	0.850 (0.722, 0.961)	0.318 (0.200, 0.450)	0.616 (0.450, 0.778)

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^a Model 1 adjusted for age, sex, education, and marital status. Model 2 additionally adjusted for APOE genotype and the Framingham cardiovascular disease (CVD) risk score. Model 3a further adjusted for PC1, whereas Model 3b further adjusted for PC1 and PC2. ^b NPV was not estimable when no participants were classified as negative by the model. PPV: positive predictive value; NPV: negative predictive value; CART: classification and regression trees.

Supplementary materials

The supplementary materials for this article are available at: https://www.explorationpub.com/uploads/Article/file/1001436_sup_1.pdf.

Declarations

Acknowledgments

During the preparation of this work, the authors used ChatGPT-5.6 to improve language and grammar. After using the tool/service, the authors reviewed and edited the content as needed and take full responsibility for the content of the publication.

Author contributions

TL: Data curation, Formal analysis, Methodology, Visualization, Writing—original draft, Writing—review & editing. HD: Conceptualization, Methodology, Writing—review & editing. PHH: Conceptualization, Methodology, Writing—review & editing, Supervision, Investigation. All authors read and approved the submitted version.

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

The study protocol was approved by the Boston University Medical Campus Institutional Review Board (IRB; approval number H-43332). The study was conducted in accordance with the Declaration of Helsinki.

Consent to participate

Written informed consent was obtained from all participants prior to enrollment in FHS.

Consent to publication

Informed consent to publication was obtained from relevant participants.

Availability of data and materials

The datasets analyzed in this study were obtained from the Framingham Heart Study and are not publicly available due to data use agreements and participant privacy protections. Requests for access to these datasets should be directed to the Framingham Heart Study through https://www.framinghamheartstudy.org/fhs-for-researchers/.

Funding

Support for this work came from the Alzheimer’s Association (grant number [23AARF-1019048]) and from the National Institute on Aging (grant number [U19AG068753]), as well as the Framingham Heart Study of the National Heart Lung and Blood Institute of the National Institutes of Health and Boston University School of Medicine. This project has been funded in whole or in part with Federal funds from the National Heart Lung and Blood Institute, Department of Health and Human Services, under Contract No. [75N92019D00031]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Open Exploration maintains a neutral stance on jurisdictional claims in published institutional affiliations and maps. All opinions expressed in this article are the personal views of the author(s) and do not represent the stance of the editorial team or the publisher.

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