P3‐298: Impact of Hypertension on Delusion in Patients with Severe Alzheimer’s Disease
Bibliographic record
Abstract
Expression of Alzheimer’s disease (AD) is modulated by vascular risk factors (vrf). Studies have shown that vrf affect cognitive function during the early stages of AD. In addition, vascular pathology, thought to be caused by vrf, is also associated with cognitive decline. The aim of our study is to investigate the relationship between hypertension, cognitive function and psychosis in patients with severe AD, and whether the mechanism is mediated through vascular pathology. Data were obtained from the National Alzheimer’s Coordinating Center (NACC) using the Uniform Data Set (UDS) and neuropathology (NP) dataset. Using the NP dataset, subjects with high probability of Alzheimer’s disease based on NIA/AA Reagan criteria, with frequent neuritic plaque on CERAD and Braak and Braak stage of V or VI were included in the analysis. The NP dataset was also used to identify the presence of vascular pathology. The presence of vrf, and the scores for MMSE, FAQ, CDR, and NPI-Q scores for delusions and hallucinations were obtained using the UDS. We identified 1515 patients with high probability of Alzheimer’s disease. In severe AD, history of hypertension did not impair cognitive or functional performance based on MMSE, FAQ and global CDR, corrected for age. There was a positive association between hypertension and psychosis, specific to delusions and not found for hallucinations. Patients with a history of hypertension were more likely to have vascular pathology, including microinfarcts, lacunae, and subcortical arteriosclerotic leukoencephalopathy (SAL). There was no association of microinfarcts and lacunae with psychosis, but a positive association was found between SAL and both types of psychosis. However, in patients with a history of hypertension, vascular pathology including presence of SAL, was not more common in patients with psychosis. In patients with severe AD, hypertension is not a risk factor for cognitive and functional impairment, but is associated with delusion. Although there are independent associations between hypertension with vascular pathology, and SAL with psychosis, our analyses show that the association between hypertension and delusions is mediated by mechanisms other than the presence of vascular pathology.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
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".