Higher Degree of Carotid Artery Stenosis is Associated with Worse Cognition (S45.005)
Notice bibliographique
Résumé
Objective: To test the hypothesis that severity of carotid stenosis is inversely correlated with cognitive measures. Background: Studies have suggested that ischemic stroke from carotid stenosis may lead to cognitive impairment. However, the relationship between the degree of carotid stenosis and cognition has not been established. Design/Methods: We performed a cross-sectional study across one health care system, assessing patients with carotid Duplex ultrasound and the Montreal Cognitive Assessment (MoCA) that were done within one year from 2018 to 2022. Carotid stenosis was defined using Doppler velocity parameters as <50% normal, 50–69% moderate, 70–99% high-grade, and occluded. Cognition was quantified using MoCA where cognitive impairment was defined as MoCA <18. Multivariable regression analyses were performed to evaluate the linear relationship between carotid stenosis parameters and MoCA, and the odds of cognitive impairment across severity of carotid stenosis. Interaction analyses by age and stroke were performed. Results: Of 1,172 patients included in the study, 73.0%, 16.8%, 8.4% and 1.8% had normal, moderate, high-grade, and occluded carotids. Mean age was 73±12 years, 41.5% were female, 17.1% had prior stroke. ICA/CCA ratio was inversely associated with MoCA scores (β-coefficient=−0.362, p=0.010). Mean MoCA decreased with increasing degree of carotid stenosis (normal=20.8, moderate=20.4, high-grade=19.4, occluded=18.7;trend-p=0.021). There was a dose-dependent relationship between degree of carotid stenosis and cognitive impairment: Adjusted odds of cognitive impairment were 1.31, 2.14, 2.73 across patients with moderate, high-grade and occluded carotids (trend-P=0.016). Interaction analyses showed that age modified the relationship between carotid stenosis and cognition (p=0.003) where the association was observed in patients age ≥65 years (aOR=3.04, p=0.001) but not in age<65 years (aOR=0.46, p=0.175). No interaction was observed with stroke. Conclusions: Our study showed an inverse relationship between degree of carotid stenosis and cognition, particularly in patients 65 years or older. Future trials may consider testing whether carotid revascularization may prevent further cognitive decline in selected populations. Disclosure: Dr. Lin has nothing to disclose. Mr. Mateti has nothing to disclose. Dr. Erben has nothing to disclose. Dr. Barrett has nothing to disclose. The institution of Dr. Taner has received research support from NIH. Dr. Brott has nothing to disclose. The institution of Dr. Meschia has received research support from NINDS. The institution of Dr. Meschia has received research support from NINDS.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,012 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».