Abstract 49: Cerebral Microbleeds are Associated With Incident Dementia: The Framingham Heart Study
Bibliographic record
Abstract
Background: CMB represent hemorrhage-prone small vessel disease (SVD), attributed to hypertensive vasculopathy or cerebral amyloid angiopathy (CAA). CMB are associated with adverse outcomes including prevalent stroke and dementia, but the relation with incident dementia in the community has not been studied. Objective: To study the association of cerebral microbleeds (CMB) on MRI and incidence of dementia in a community based cohort. Methods: We evaluated 1296 dementia-free Framingham Original and Offspring Cohort participants (mean age 72years; 54% women) with available brain MRI and incident dementia data (mean follow-up 6.7 years). Using Cox-proportional hazards models we related all CMB and CMB stratified by brain location to incident dementia. Multivariable models were adjusted for age, sex, APOE status, and education, with additional models adjusting for vascular risk factors and MRI markers of ischemic SVD. Results: CMB were observed in 10.8% of subjects (64% lobar, 36% deep and mixed). Incident dementia was observed in 85 participants (6.6% over study period). We observed a 1.74 times higher risk of dementia in participants with any CMB (HR 1.74, 95% CI 1.00-3.01), and three fold higher risk in those with deep and/or mixed CMB (HR 2.99, 95% CI 1.52-5.90). The associations remained significant after adjusting for vascular risk factors. Although they were attenuated after adjustment for MRI markers of ischemic SVD, they remained significant for participants with deep and/or mixed CMB (HR 2.44, 95% CI 1.22-4.88). Purely lobar CMB were not associated with incident dementia. Conclusions: CMB were associated with increased risk of incident dementia, and for non-lobar CMB, the associations were independent of vascular risk factors and ischemic markers of small vessel disease. Our findings support a role for hypertensive vasculopathy and the interplay of hypertensive and cerebral amyloid angiopathy in risk of dementia, and highlight the role of CMB as markers of adverse neurological outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".