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01.
arXiv (math.PR) 2026-06-18

Rigidity of infinite exchangeable sequences with Gaussian marginals

arXiv:2606.18654v1 Announce Type: new Abstract: We study infinite exchangeable sequences with Gaussian one-dimensional marginals. We formulate the conjecture that joint Gaussianity of a single pair of coordinates forces the entire sequence to be a Gaussian process. Although this conjecture remains open, we prove that joint Gaussianity of the first four coordinates is sufficient. We also establish the corresponding two-point criterion under the additional assumption that the directing measure is almost surely infinitely divisible.

02.
arXiv (CS.AI) 2026-06-19

AI4SE and SE4AI Exploration: A Decade Looking Back and Forward

arXiv:2606.19630v1 Announce Type: new Abstract: The March 2020 INCOSE INSIGHT special issue on AI and Systems Engineering (SE) became the most downloaded issue in the publication's history and launched a research community that now draws over 250 registrants to its annual workshop. In this article, we trace the progress in AI and SE across three phases (labeled here foundational, applied, and LLM inflection) based on the authors' reading of the field's core papers, and describe our opinions of where the community has converged and where critical gaps remain. Separately, a human-AI agreement literature review leveraging both human expertise and six AI models was performed to assess the relevance of 1,712 INCOSE INSIGHT articles and 889 SERC publications. The results identify five critical research gaps and offer guidance for practitioners navigating AI adoption, assurance, and workforce transformation in SE. We share the agreement data and the AI4SE/SE4AI Explorer web application so readers can compare their own relevance judgments with the human and AI raters.

03.
arXiv (CS.AI) 2026-06-19

Configurable Clinical Information Extraction with Agentic RAG: What Works, What Breaks, and Why

arXiv:2606.19602v1 Announce Type: new Abstract: Patient contexts span hundreds of heterogeneous documents and thousands of structured data points, yet the document-level metadata that AI systems need for retrieval and triage is absent or incomplete. Standard retrieval-augmented generation fails on this data, mishandling temporal reasoning, cross-document dependencies, and missing metadata. We deploy ACIE (Agentic Clinical Information Extraction) at University Medicine Essen: an on-premise agentic RAG pipeline that reasons over complete patient contexts and grounds every answer in source passages for clinician verification. We quantify the metadata gap, trace the architectural decisions it shaped, and evaluate extraction alongside an independent retrospective lymphoma registry study, in which nuclear-medicine physicians verify every extracted value against its cited sources. Across 7,326 judgments, clinicians accepted 96.5\% of extractions, with per-type acceptance ranging from 80\% to 99\%.

04.
arXiv (CS.CV) 2026-06-11

Motion Reinforces Appearance: RGB-Skeleton Gated Residual Fusion for Micro-Gesture Online Recognition

Micro-gesture analysis attracts increasing attention for inferring spontaneous emotion from subtle body movements. Micro-gesture online recognition, which localizes and classifies each gesture instance in untrimmed videos, is a core task in the 4th EI-MiGA-IJCAI Challenge. Compared with typical temporal action detection, MGR emphasizes the localization and classification of actions, requiring the model to output the start time, end time, and category of each micro-gesture. Moreover, since micro-gestures are highly spontaneous, relying solely on a single modality makes it difficult to capture the complete and accurate multi-modal cues. In this work, we propose DyFADet+, which extends DyFADet into a dual-stream RGB-skeleton framework. In our model, both modalities are projected into shared multi-scale temporal embeddings and fused through a gated residual module, which adaptively injects skeleton motion into the RGB representation rather than using naive concatenation. Finally, these fused features are decoded by a Dynamic TAD head for online classification and boundary regression. On the SMG dataset, our method achieves an F1 score of 40.88, ranking 2nd in the Micro-gesture Online Recognition track.

05.
arXiv (CS.LG) 2026-06-19

Improved Stochastic Optimization of LogSumExp

arXiv:2509.24894v4 Announce Type: replace-cross Abstract: The LogSumExp function, dual to the Kullback-Leibler (KL) divergence, plays a central role in many important optimization problems, including entropy-regularized optimal transport (OT) and distributionally robust optimization (DRO). In practice, when the number of exponential terms inside the logarithm is large or infinite, optimization becomes challenging since computing the gradient requires differentiating every term. We propose a novel convexity- and smoothness-preserving approximation to LogSumExp that can be efficiently optimized using stochastic gradient methods. This approximation is rooted in a sound modification of the KL divergence in the dual, resulting in a new $f$-divergence called the Safe KL divergence. Our experiments and theoretical analysis of the LogSumExp-based stochastic optimization, arising in DRO and continuous OT, demonstrate the advantages of our approach over existing baselines.

06.
arXiv (quant-ph) 2026-06-17

Cavity-enhanced superconducting response in an underdoped cuprate

arXiv:2606.18084v1 Announce Type: cross Abstract: Superconductors carry electrical current without resistance when paired electrons condense into a coherent macroscopic quantum state. In underdoped cuprates, evidence suggests that pairing-related correlations and superconducting fluctuations can survive above the temperature at which global coherence is lost, pointing to phase fluctuations as a key limitation on superconductivity in this regime. Motivated by recent demonstrations of cavity-modified collective states in quantum materials, we investigate whether superconducting coherence can be stabilized by engineering the electromagnetic environment of the superconductor. We study an underdoped YBa$_2$Cu$_3$O$_{7-\delta}$ thin film in a tunable terahertz cavity formed with a semi-transparent gold mirror. From temperature-dependent terahertz transmission measurements, we find that the cavity enhances the superconducting response below the critical temperature, with an increase of the inferred superfluid weight. The effect becomes more pronounced at smaller cavity lengths and is accompanied by an upward shift of the superconducting onset temperature. Calculations based on a cavity-coupled model for phase-fluctuating superconductors capture these trends and support an interpretation in terms of cavity-enhanced phase stiffness. These results showcase the potential of cavity engineering for designing emergent functionalities in correlated systems.

07.
arXiv (CS.LG) 2026-06-16

Size Doesn't Matter: Cosine-Scored Sparse Autoencoders

arXiv:2606.15054v1 Announce Type: new Abstract: Sparse autoencoders (SAEs) detect features via inner product, so a feature's activation scales with both its directional alignment and the input's norm. Under BatchTopK, high-norm tokens inflate all pre-activations simultaneously, claiming dictionary slots regardless of content alignment. This matters because sublayer normalization has already discarded the magnitude the score measures, so the encoder detects a quantity the model does not read. We replace the score with a learned blend of cosine similarity and input magnitude, letting the optimizer choose how much norm to use; a per-feature extension lets each feature decide independently. In both regimes, training is free to recover inner product but never does, with no feature ever choosing more than half-magnitude dependence. At matched reconstruction, the cosine encoder learns features that align with human-recognizable concepts far more often than standard, filling dictionary slots that inner product wastes on norm detectors. Loss reweighting that equalizes gradients barely closes the gap, confirming forward-pass score geometry as the lever. The advantage is not universal across tasks or depths, but we believe cosine scoring should be the default for dictionary learning on normalized representations.

08.
arXiv (math.PR) 2026-06-12

Dimension-free Markov–Bernstein inequalities for product measures

Authors:

arXiv:2606.13575v1 Announce Type: cross Abstract: We study dimension-free Markov–Bernstein inequalities for polynomials with respect to product probability measures. In the Gaussian case, for $p\ge4$, we prove that \[ \|\nabla f\|_{L^p(\gamma^n)} \le C(p)d^{\frac12+\theta_p} \|f\|_{L^p(\gamma^n)} \] for every polynomial $f$ of degree at most $d$, where $\theta_p\le \frac{2}{3p}$ and $\theta_p=0$ whenever $p$ is an even integer. Thus, for even integer exponents, we establish the sharp dependence on the degree conjectured by Eskenazis–Ivanisvili. For general $p\ge4$, the estimate improves upon their dimension-free inequality. We also obtain dimension-free Markov–Bernstein inequalities with sharp dependence on the degree for even integer exponents beyond the Gaussian setting. We first prove such estimates for the uniform distribution on the unit cube and then extend them to products of absolutely continuous measures with unimodal densities. Finally, we treat products of one-dimensional Freud measures with densities proportional to $e^{-|t|^{2m}}$.

09.
arXiv (CS.CL) 2026-06-16

HK-LegiCoST: Leveraging Non-Verbatim Transcripts for Speech Translation

We introduce HK-LegiCoST, a new three-way parallel corpus of Cantonese-English translations, containing 600+ hours of Cantonese audio, its standard traditional Chinese transcript, and English translation, segmented and aligned at the sentence level. We describe the notable challenges in corpus preparation: segmentation, alignment of long audio recordings, and sentence-level alignment with non-verbatim transcripts. Such transcripts make the corpus suitable for speech translation research when there are significant differences between the spoken and written forms of the source language. Due to its large size, we are able to demonstrate competitive speech translation baselines on HK-LegiCoST and extend them to promising cross-corpus results on the FLEURS Cantonese subset. These results deliver insights into speech recognition and translation research in languages for which non-verbatim or ``noisy'' transcription is common due to various factors, including vernacular and dialectal speech.

11.
arXiv (CS.CV) 2026-06-17

Colab NAS: Obtaining lightweight task-specific convolutional neural networks following Occam's razor

The current trend of applying transfer learning from convolutional neural networks (CNNs) trained on large datasets can be an overkill when the target application is a custom and delimited problem, with enough data to train a network from scratch. On the other hand, the training of custom and lighter CNNs requires expertise, in the from-scratch case, and or high-end resources, as in the case of hardware-aware neural architecture search (HW NAS), limiting access to the technology by non-habitual NN developers. For this reason, we present ColabNAS, an affordable HW NAS technique for producing lightweight task-specific CNNs. Its novel derivative-free search strategy, inspired by Occam's razor, allows to obtain state-of-the-art results on the Visual Wake Word dataset, a standard TinyML benchmark, in just 3.1 GPU hours using free online GPU services such as Google Colaboratory and Kaggle Kernel.

12.
arXiv (CS.LG) 2026-06-19

Tracking Representation Dynamics in Large Language Models with Persistent Homology

arXiv:2606.19542v1 Announce Type: new Abstract: Large language models are commonly aligned through supervised fine-tuning, yet little is known about how their internal representations evolve during this process. We study alignment dynamics using persistent homology by tracking the topology of activation spaces throughout fine-tuning. Across four transformer language models ranging from 1B to 7B parameters and three alignment objectives corresponding to helpful, harmless, and mixed training data, we find that the majority of topological reorganization occurs during the earliest stages of training. A dense checkpoint analysis reveals a transient peak in topological activity followed by rapid stabilization. We further show that different alignment objectives induce distinguishable topological trajectories, while instruction-tuned and pretrained models exhibit qualitatively different patterns of evolution. Our results suggest that persistent homology provides a complementary perspective on alignment, revealing representation-level changes that are not apparent from behavioral metrics alone.

13.
Nature (Science) 2026-06-12

Daily briefing: How Venus flytraps snap shut

Authors:

Softening cells enable flytraps to shut with astonishing speed. Plus, the cutting-edge science happening at the World Cup and why scientists shouldn’t ignore the Pope’s AI message. Softening cells enable flytraps to shut with astonishing speed. Plus, the cutting-edge science happening at the World Cup and why scientists shouldn’t ignore the Pope’s AI message.

14.
arXiv (CS.AI) 2026-06-16

TS-Memory: Plug-and-Play Memory for Time Series Foundation Models

arXiv:2602.11550v2 Announce Type: replace-cross Abstract: Time Series Foundation Models (TSFMs) achieve strong zero-shot forecasting through large-scale pre-training, but adapting them to downstream domains under distribution shift remains challenging. Existing solutions face a trade-off: Parametric Adaptation can cause catastrophic forgetting and requires costly multi-domain maintenance, while Non-Parametric Retrieval improves forecasts but incurs high inference latency due to datastore search. We propose Parametric Memory Distillation and implement it as TS-Memory, a lightweight memory adapter that augments frozen TSFMs. TS-Memory is trained in two stages. First, we construct an offline, retrieval-leakage-safe kNN teacher that synthesizes confidence-aware quantile targets from retrieved futures. Second, we distill this retrieval-induced distributional correction into a lightweight memory adapter via confidence-gated supervision. During inference, TS-Memory fuses memory and backbone predictions with constant-time overhead, enabling retrieval-free deployment. Experiments across diverse TSFMs and benchmarks demonstrate consistent improvements in both point and probabilistic forecasting over representative adaptation methods, with efficiency comparable to the frozen backbone. Code: https://github.com/sisuolv/TS-Memory.

15.
arXiv (CS.AI) 2026-06-18

TRIDENT: Breaking the Hybrid-Safety-Physics Coupling for Provably Safe Multi-Agent Reinforcement Learning

arXiv:2606.18308v1 Announce Type: cross Abstract: Safe coordination in networked cyber-physical systems forces learning algorithms to simultaneously handle hybrid discrete-continuous actions, hard training-time safety constraints, and physics-governed dynamics. We show that these three features form a directed cycle of biases that defeats any naive composition of off-the-shelf modules, and formalize this as a three-way coupling lemma. We then introduce TRIDENT, the first MARL framework whose three components are co-designed to cancel each leak: a Richardson-Romberg gradient correction reducing Gumbel-Softmax bias from O(tau) to O(tau^2), a Lyapunov-constrained sequential trust-region update enforcing per-iterate feasibility, and a physics-informed residual critic that decomposes value rather than reward. We prove an O~(1/sqrt(K)) convergence rate to a constrained Nash equilibrium and an O(sqrt(K)) cumulative-violation bound. On multi-UAV mobile-edge computing, autonomous intersection management, and a hybrid SMAC variant, TRIDENT cuts training-time violations by 95.5% over MADDPG and 76.3% over MACPO, while improving reward by 13.5% over the strongest unconstrained baseline.

16.
arXiv (CS.AI) 2026-06-19

Denoising Implicit Feedback for Cold-start Recommendation

arXiv:2606.19658v1 Announce Type: new Abstract: Implicit feedback is widely used in recommender systems due to its accessibility and generality, yet it usually presents noisy samples (e.g., clickbait, position bias). Meanwhile, recommenders inevitably face the item cold-start problem due to the continuous influx of new items. We identify that cold items are more prone to noisy samples due to the aforementioned factors, and researchers often overlook the significance of denoising implicit feedback for cold items. Previous denoising studies usually identify noisy samples based on heuristic patterns, such as higher loss values, and mitigate noise through sample selection or re-weighting. However, these methods have limited adaptability and are ineffective in cold-start scenarios. To achieve denoising implicit feedback for cold-start recommendation, we propose a model-agnostic denoising method called DIF. First, user preferences for content remain stable, which allows us to infer pseudo-labels indicating whether a user is interested in a cold item through content-similar warm items. Furthermore, to improve pseudo-label accuracy, we model the confidence of pseudo-labels based on the content similarity between the cold item and warm items, and then aggregate multiple pseudo-labels for each sample. Finally, we explicitly estimate the uncertainty of the noisy sample label by considering its relative entropy and the cold-start status of the item, which adaptively guides the role of pseudo-labels to correct the noisy labels at the sample level. DIF's superiority is supported by both theoretical justification and extensive experiments on real-world datasets. The method has been deployed on a billion-user scale short video application Kuaishou and has significantly improved various commercial metrics within cold-start scenarios.

17.
arXiv (CS.CL) 2026-06-11

RLCSD: Reinforcement Learning with Contrastive On-Policy Self-Distillation

On-policy self-distillation (OPSD) provides dense, token-level supervision for reasoning models by aligning a model's own distribution with the distribution it produces under privileged context, typically a verified solution. However, we show that the learning signal drawn from this distributional gap concentrates on style tokens rather than task-bearing ones, as the hinted model tends to produce more direct, shorter outputs. We term this pathology privilege-induced style drift, which destabilizes training or causes response length to shrink. To address this, we propose RLCSD (Reinforcement Learning with Contrastive on-policy Self-Distillation), which mitigates this drift by contrasting the teacher-student gap under a correct hint against that under a wrong hint, suppressing the style shift that conditioning on a hint tends to induce regardless of correctness, and yielding a signal that is more concentrated on task-bearing tokens. Experiments on Qwen3 (1.7B/4B/8B) and Olmo-3-7B-Think across mathematical and logical reasoning show that RLCSD consistently outperforms GRPO and prior OPSD methods. We further show that the contrastive principle is general: it plugs into existing OPSD methods to improve them, and its underlying insight extends to the broader cross-model on-policy distillation setting.

18.
arXiv (CS.CV) 2026-06-12

Efficient, Robust, and Anti-Collusion Fingerprinting of Image Diffusion Models

Model fingerprinting, embedding user-specific identifiers (fingerprints) into generated outputs, has recently emerged as a popular solution to protect the intellectual property rights (IPR) of generative text-to-image (T2I) models and prevent unauthorized redistribution. In this work, we reveal a previously unexplored systematic vulnerability in existing generative model fingerprinting methods: they lack robustness against collusion attacks, where multiple attackers combine their models to remove or obscure the fingerprints. To address this issue, we take the first step towards a robust fingerprinting method for T2I models with anti-collusion capabilities. The proposed method encodes strings of bits, namely fingerprints, into the coefficients of a personalized normalization module (PNM) incorporated into T2I models, so that fingerprints can be reliably recovered from any generated image. To defend against collusion attacks and prevent unauthorized model redistribution, we introduce an anti-collusion mechanism based on lossless function-invariant parameter transformations. This mechanism significantly degrades the image generation quality of colluded models, making them effectively unusable. Moreover, our method allows developers to efficiently create multiple copies of fingerprinted T2I models by reparameterizing the PNM without the need for retraining. We also introduce a worst-case optimization strategy to improve robustness against model-level attacks. Our experiments demonstrate that the proposed method achieves high fidelity and robustness across multiple T2I image generation and editing tasks, with fingerprint extraction accuracy exceeding 99.5%. Compared with existing methods, our method demonstrates, for the first time, a notable proactive robustness to collusion attacks by significantly increasing the FID of colluded models.

19.
arXiv (math.PR) 2026-06-18

Cramér-Type Moderate Deviations for Engel's Series via a Martingale Approach

arXiv:2606.18866v1 Announce Type: new Abstract: Let $x$ be uniformly distributed on $(0,1)$, and let $(q_n)_{n\geq1}$ be the digits of its Engel series expansion. We establish a Cramér-type moderate deviation expansion for $(\log q_n-n)/\sqrt n$. The proof is based on a martingale decomposition and asymptotic results for martingales. As consequences, we obtain a moderate deviation principle over the full range of scales between the central limit theorem and the law of large numbers, without the additional lower rate restriction required in several earlier works. We also derive a uniform Berry–Esseen bound of order $(\log n)/\sqrt n$.

20.
arXiv (CS.LG) 2026-06-16

Physics-conforming Latent Twins

arXiv:2606.15053v1 Announce Type: new Abstract: Surrogate models are central to scientific machine learning, where they enable fast prediction, simulation, inference, and control for complex physical systems. For time-dependent problems, however, accurate interpolation of training trajectories is not sufficient: reliable surrogates should also respect the conservation laws, invariants, admissibility conditions, and dissipative structures that give those trajectories physical meaning. We introduce Physics-conforming Latent Twins, a framework for learning latent surrogate solution operators whose dynamics satisfy selected physical principles by design. The method builds on the Latent Twin formulation by jointly learning an encoder, a decoder, and a latent flow map between arbitrary time-indexed states, while constraining the latent dynamics to preserve or dissipate prescribed structural quantities. We develop a constraint-transfer viewpoint that connects physical structure in the original state space with compatible constraints in latent space, and prove structure-preservation bounds showing how latent enforcement improves control of physical defects after decoding. We also derive algebraic conditions for latent flow maps that preserve linear and quadratic invariants or enforce dissipative inequalities. Numerical experiments on representative ODE and PDE benchmarks demonstrate improved constraint satisfaction, structural fidelity, and qualitative long-time behavior while maintaining accurate surrogate prediction.

21.
arXiv (CS.CL) 2026-06-15

Large Language Model Agents Are Not Always Faithful Self-Evolvers

Self-evolving large language model (LLM) agents continually improve by accumulating and reusing past experience, yet it remains unclear whether they faithfully rely on that experience to guide their behavior. We present the first systematic investigation of experience faithfulness, the causal dependence of an agent's decisions on the experience it is given, in self-evolving LLM agents. Using controlled causal interventions on both raw and condensed forms of experience, we comprehensively evaluate four representative frameworks across 13 LLM backbones and 9 environments. Our analysis uncovers a striking asymmetry: while agents consistently depend on raw experience, they often disregard or misinterpret condensed experience, even when it is the only experience provided. This gap persists across single- and multi-agent configurations and across backbone scales. We trace its underlying causes to three factors: the semantic limitations of condensed content, internal processing biases that suppress experience, and task regimes where pretrained priors already suffice. These findings challenge prevailing assumptions about self-evolving methods and underscore the need for more faithful and reliable approaches to experience integration.

22.
arXiv (CS.LG) 2026-06-16

Decoupling Inference from State Updates in Low-Latency Feature Engines via Probabilistic Thinning

arXiv:2606.16981v1 Announce Type: cross Abstract: Streaming data systems increasingly underpin Machine Learning workflows that maintain large numbers of continuously updated aggregations. In production settings, each incoming event typically triggers read-modify-write operations to persistent storage, making high-frequency state updates a dominant source of latency, contention, and operational cost. In this work, we decouple inference from state persistence in streaming Machine Learning pipelines via probabilistic thinning: every event is scored, but durable state updates are selectively triggered by informative events. Unlike approaches that shed input or state, we show that persistence-path control is achievable without a high-frequency in-memory control plane or cross-worker coordination, relying exclusively on approximate statistics retrieved from disk-backed key-value stores. We model the resulting stochastic processes, derive bounds on filtering rates, and prove that common time-based aggregations remain unbiased under variance-aware formulations, preventing systemic error accumulation. We evaluate the approach in a controlled setting that isolates per-event costs, demonstrating substantial reductions in storage Input/Output and serialization overhead. Across experiments, up to 90% of events are excluded from the persistence path while preserving and in some cases improving downstream utility.

23.
arXiv (CS.CV) 2026-06-15

GMN4AD: Graph Matching Network for Alzheimer's Disease Diagnosis with Test-Time Domain Adaptation using Multi-centered Structure Magnetic Resonance Imaging

Alzheimer's Disease (AD) is a progressive neurodegenerative disorder that affects millions of older adults, with prevalence expected to rise significantly in the coming years. Early diagnosis, particularly during the mild cognitive impairment (MCI) stage, is critical for timely intervention. Structural Magnetic Resonance Imaging (sMRI) has emerged as a key modality for detecting AD-related brain changes, but traditional graph-based approaches often struggle with modality and inter-site heterogeneity, limiting diagnostic performance. In this paper, we propose Graph Matching Network for Alzheimer's Disease Diagnosis (GMN4AD), designed to model interactions between heterogeneous brain graphs derived from neuroimaging data. Unlike conventional methods that treat each brain graph independently, GMN4AD leverages graph matching to capture cross-graph relationships, enhancing diagnostic precision. Furthermore, we introduce a test-time domain adaptation strategy that combines contrastive learning to mitigate domain shifts during inference. Extensive experiments on three public AD datasets demonstrate that GMN4AD achieves superior performance compared to state-of-the-art methods, offering a robust and generalizable solution for AD diagnosis.

24.
arXiv (math.PR) 2026-06-16

Flowing to Normality and the Fate of the Single Ring Theorem

arXiv:2606.15791v1 Announce Type: cross Abstract: Random non-hermitian matrix ensembles with double-sided rotation invariance obey, in the limit of large matrix size, the Single Ring Theorem, which states that the support of the mean eigenvalue distribution in the complex plane is either a disk or an annulus. In contrast, rotational-invariant random normal matrix ensembles can have mean eigenvalue densities supported over any number of concentric annuli in the complex plane. In this paper we introduce and investigate, both analytically and numerically, a non-hermitian matrix model which flows from a generic matrix distribution obeying the Single Ring Theorem to a distribution of normal matrices by tuning a parameter which penalizes non-normality. We observe numerically breakdown of the Single Ring Theorem as the model flows towards normality, and determine the critical value of the parameter at which the transition occurs. We also study in detail the behavior of the singular values of these matrices under the flow. These singular values form a Fermi gas confined to the positive half-line. In particular, we find that at small values of the flow parameter, the interparticle spacings in the gas exhibit Wigner-Dyson repulsion, whereas for asymptotically large values of the flow parameter, at the normal matrix endpoint of the flow, the spacing statistics is Poissonian. The flow interpolates continuously between these two types of statistics. However, this change in statistics is not related directly to breaking of the Single Ring Theorem, which occurs very early-on along the flow, in the regime of Wigner-Dyson statistics. Finally, we introduce a certain ensemble of random permutations associated with the gas, and make a conjecture on how to use it in order to reconstruct approximately the average density of complex eigenvalues from that of the singular values in the large-$N$ limit.

25.
medRxiv (Medicine) 2026-06-15

Instrumental Activities of Daily Living in Older Adults with Epilepsy: A Cross-Sectional and Longitudinal Multicenter Study

Objective: Instrumental activities of daily living (IADLs) represent a critical but understudied measure of day-to-day function in persons with epilepsy(PWE). In the multicenter Brain Aging and Cognition in Epilepsy (BrACE) study of PWE aged greater than or equal to 55 years, we examined the proportion, clinical correlates, epilepsy-related predictors, and longitudinal trajectory of IADL impairment. Methods: IADLs were assessed using the Functional Activities Questionnaire (FAQ; range=0 to 30; higher=more impaired); a FAQ greater than or equal to 2 defines MCI-level impairment, and a FAQ greater than or equal to 5 defines dementia-level functional impairment. Multivariable logistic regression identified predictors of baseline function. Global cognition (Montreal Cognitive Assessment [MoCA]), individual cognitive measures, and quality of life (QOL) were compared between the impaired and unimpaired groups. Linear regression evaluated predictors of longitudinal functional decline. Results: Of 57 participants (mean age=66.6 years; female=52.6%), 38.6% (n=22) had MCI-level functional impairment and 17.5% (n=10) had dementia-level functional impairment. In univariate analyses, worse FAQ scores were associated with lower education, higher area deprivation index, early-onset epilepsy (EOE less than 60 years), antiseizure medication polytherapy, and epilepsy localization. In multivariable analysis, temporal lobe epilepsy (OR=4.46, 95% CI=1.09, 21.83,p=0.047), EOE(OR=7.14, 95% CI=1.16, 59.97, p=0.046), and lower education(OR=0.70,95% CI=0.49, 0.93, p=0.025) remained independently associated with baseline MCI-level functional-impairment. Lower education (OR=0.55,95% CI=0.29, 0.84, p=0.021) was the only factor associated with dementia-level IADL-impairment. IADL-impaired participants demonstrated lower verbal memory scores (adjusted p=0.041) and MoCA scores (adjusted p