Machine Learning Driven by Magnetic Resonance Imaging for the Classification of Alzheimer Disease Progression: Systematic Review and Meta-Analysis

Background: To diagnose Alzheimer disease (AD), individuals are classified according to the severity of their cognitive impairment. There are currently no specific causes or conditions for this disease. Objective: The purpose of this systematic review and meta-analysis was to assess AD prevalence across different stages using machine learning (ML) approaches comprehensively. Methods: The selection of papers was conducted in 3 phases, as per PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) 2020 guidelines: identification, screening, and final inclusion. The final analysis included 24 papers that met the criteria. The selection of ML approaches for AD diagnosis was rigorously based on their relevance to the investigation. The prevalence of patients with AD at 2, 3, 4, and 6 stages was illustrated through the use of forest plots. Results: The prevalence rate for both cognitively normal (CN) and AD across 6 studies was 49.28% (95% CI 46.12%-52.45%; P=.32). The prevalence estimate for the 3 stages of cognitive impairment (CN, mild cognitive impairment, and AD) is 29.75% (95% CI 25.11%-34.84%, P<.001). Among 5 studies with 14,839 participants, the analysis of 4 stages (nondemented, moderately demented, mildly demented, and AD) found an overall prevalence of 13.13% (95% CI 3.75%-36.66%; P<.001). In addition, 4 studies involving 3819 participants estimated the prevalence of 6 stages (CN, significant memory concern, early mild cognitive impairment, mild cognitive impairment, late mild cognitive impairment, and AD), yielding a prevalence of 23.75% (95% CI 12.22%-41.12%; P<.001). Conclusions: The significant heterogeneity observed across studies reveals that demographic and setting characteristics are responsible for the impact on AD prevalence estimates. This study shows how ML approaches can be used to describe AD prevalence across different stages, which provides valuable insights for future research.