Abstract TP187: 24-hour Ambulatory Blood Pressure, Cognitive Performance, and Cerebral Microbleeds in the Elderly
Bibliographic record
Abstract
Introduction: Multiple studies suggest a role for blood pressure (BP) variability and nocturnal BP dipping in the development of cerebrovascular disease and cognitive impairment. We analyzed cross-sectional data from a cohort of 90+ year-olds to test the hypothesis that BP variables are associated with cognitive function and cerebral microbleeds (CMB). Methods: Study subjects were 121 participants (mean age = 93 years, 63% female) in The 90+ Study , a study of aging in individuals aged 90 years and older from a California retirement community. Participants were given a neuropsychological test battery to determine cognitive status. All subjects underwent 24-hour ambulatory BP measurement with a automatic device. MRI scans were available for 26 participants. Over three time frames (24-hour, daytime, nighttime) and separately for SBP and DBP, we represented BP by mean, minimum, maximum, standard deviation (SD), coefficient of variation, average real variability, percentage of high measurements (≥140 mmHg for SBP and ≥90 mmHg for DBP), percentage of low measurements (<90 mmHg for SBP and <60 mmHg for DBP), and nocturnal dip (% change of mean night BP from mean day BP). Differences in means of BP variables between groups based on cognitive status (normal vs cognitively impaired not demented (CIND)/demented) and presence/absence of CMB were tested using t-tests. Results: Cognitive status was normal in 97 subjects, CIND/demented in 24. Mean nocturnal dips (both SBP and DBP) differed significantly between the two groups, with normal participants having on average greater dip levels (6.6 vs 1.3, p=0.006 for SBP and 11 vs 4.4, p=0.002 for DBP). No other BP variable showed a large or significant difference. Greater nocturnal dips were also related to better performance on cognitive test scores related to language, recent memory, and visual-spatial ability. MRI findings showed subjects with CMB (n=18) had higher SD of daytime SBP than those without (n=8) (20 vs 16, p=0.03). Those with CMB also had a greater proportion of high nighttime DBP (≥90 mmHg) readings (3.6 vs 0, p=0.03). Conclusions: Among 90+ year olds, altered nocturnal BP dipping may have a role in cognitive impairment, while SBP variation and diastolic hypertension may contribute to development of microbleeds.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.005 | 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".