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Suspected cognitive impairment was defined as an AD8 score \u22652. Following data splitting, feature selection was processed via the Boruta algorithm. Five algorithms\u2014logistic regression, random forest, XGBoost, SVM, and EasyEnsemble\u2014were evaluated. Performance was assessed using ROC, PR, accuracy, sensitivity, specificity, PPV, NPV, NNS, DCA, calibration plots, and Brier score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The EasyEnsemble model outperformed other algorithms on the independent testing set, with an ROC-AUC of 0.696 (Bootstrap-corrected mean: 0.677; 95% CI: 0.643\u20130.713). At the clinically optimized threshold of 0.034, the model achieved a sensitivity of 60.6%, a specificity of 73.4% and a NNS of 51.9. DCA indicated a positive net benefit across a threshold range approximately from 0.03 to 0.20, suggesting potential clinical utility for triage in this setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This cross-sectional model provides a pragmatic, low-cost tool for concurrent case-finding of individuals with AD8-defined suspected cognitive impairment in primary care. However, further external validation in diverse geographic regions is mandatory before clinical implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/25424823261470033","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T11:44:42Z","timestamp":1784634282000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Machine learning-based screening for Ascertain Dementia 8-defined suspected cognitive impairment leveraging routine health check data in South China"],"prefix":"10.1177","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-4100-5083","authenticated-orcid":false,"given":"Peiyue","family":"Su","sequence":"first","affiliation":[{"name":"Sun Yat-Sen University"},{"name":"Sun Yat-Sen University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiale","family":"Li","sequence":"additional","affiliation":[{"name":"Sun Yat-Sen University"},{"name":"Sun Yat-Sen University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1305-4349","authenticated-orcid":false,"given":"Yang","family":"Hu","sequence":"additional","affiliation":[{"name":"Sun Yat-Sen University"},{"name":"Sun Yat-Sen University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Xu","sequence":"additional","affiliation":[{"name":"Sun Yat-Sen University"},{"name":"Sun Yat-Sen University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3203-4208","authenticated-orcid":false,"given":"Qianqian","family":"Ji","sequence":"additional","affiliation":[{"name":"Sun Yat-Sen University"},{"name":"Sun Yat-Sen University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7136-300X","authenticated-orcid":false,"given":"Qi","family":"Liu","sequence":"additional","affiliation":[{"name":"Sun Yat-Sen University"},{"name":"Sun Yat-Sen University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoping","family":"Huang","sequence":"additional","affiliation":[{"name":"Sun Yat-Sen University"},{"name":"Sun Yat-Sen University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruitong","family":"Liao","sequence":"additional","affiliation":[{"name":"Sun Yat-Sen University"},{"name":"Sun Yat-Sen University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liuqing","family":"Li","sequence":"additional","affiliation":[{"name":"Sun Yat-Sen University"},{"name":"Sun Yat-Sen University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yueting","family":"Liao","sequence":"additional","affiliation":[{"name":"Sun Yat-Sen University"},{"name":"Sun Yat-Sen University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunzhang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Karolinska Institutet"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifan","family":"Lin","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Shenzhen University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiqiang","family":"Zhan","sequence":"additional","affiliation":[{"name":"Sun Yat-Sen University"},{"name":"Sun Yat-Sen University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"e_1_3_3_2_2","article-title":"2025 Alzheimer\u2019s disease facts and figures","volume":"21","author":"Alzheimer\u2019s Association","year":"2025","unstructured":"Alzheimer\u2019s Association. 2025 Alzheimer\u2019s disease facts and figures. 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