Modeling mortality prediction in older adults with dementia receiving COVID-19 vaccination

Objective: This study compared COVID-19 outcomes between vaccinated and unvaccinated older adults with and without cognitive impairment. Method: Electronic health records from Israel from March 2020-February 2022 were analyzed for a large cohort (N = 85,288) aged 65 +. Machine learning constructed models to predict mortality risk from patient factors. Outcomes examined were COVID-19 mortality and hospitalization post-vaccination. Results: Our study highlights the significant reduction in mortality risk among older adults with cognitive disorders following COVID-19 vaccination, showcasing a survival rate improvement to 93%. Utilizing machine learning for mortality prediction, we found the XGBoost model, enhanced with inverse probability of treatment weighting, to be the most effective, achieving an AUC-PR value of 0.89. This underscores the importance of predictive analytics in identifying high-risk individuals, emphasizing the critical role of vaccination in mitigating mortality and supporting targeted healthcare interventions. Conclusions: COVID-19 vaccination strongly reduced poor outcomes in older adults with cognitive impairment. Predictive analytics can help identify highest-risk cases requiring targeted interventions.