How Reliable and Explainable Are Machine Learning Models for Dementia Detection? A Leakage-Aware Evaluation
This study demonstrates that while machine learning models can achieve high dementia detection performance on the OASIS-2 dataset when rigorously evaluated with participant-level cross-validation to prevent data leakage, their apparent reliance on MRI features is inconsistent and often overshadowed by the Mini-Mental State Examination (MMSE), highlighting the critical need for independent validation to ensure clinical explainability and generalizability.