P4‐286: CEREBRAL SMALL VESSEL DISEASE AND COGNITIVE DECLINE IN AN ASIAN MEMORY CLINIC POPULATION
Bibliographic record
Abstract
Cerebral small vessel disease (SVD) includes several abnormalities detected on conventional MRI, ranging from white matter hyperintensities (WMH), lacunes, to cerebral microbleeds (CMBs). SVD is considered as one of the major causes of cognitive decline, dementia and functional impairment. Longitudinal data on SVD and cognitive decline are lacking in Asian populations. Therefore, the present study aims to investigate whether baseline SVD is associated with cognitive decline over a 3 year period in a memory-clinic population. In this prospective case-control study, we studied 399 patients with baseline 3T MRI scans and at least 3 annual neuropsychological assessments. At baseline total numbers of CMBs and lacunes were recorded, along with WMH (using the Modified Fazekas Scale). The National Institute of Neurological Disorders and Stroke-Canadian Stroke Network harmonization neuropsychological battery was used to assess cognitive function. Linear regression models in generalized estimated equations with mean difference (β) and 95% confidence intervals (CI) were constructed to analyse the association between baseline SVD and cognitive decline. Models were adjusted for demographic, cardiovascular risk factors and other MRI markers. Increasing number of CMBs is associated with decline in global cognitive score. Domain specific analysis showed CMBs are associated with decline in executive function, visuomotor speed and memory domains (Figure-1). Presence of significant WMH (Fazekas≥2) is associated with decline in global cognitive score and domain specific analysis showed decline in executive function, visuomotor speed and memory domains (Figure-2). There was significant interaction effect between SVD with time; in the association between increasing number of CMBs with worse performance in global cognition (p=0.015), executive function (p=0.011), memory (p=0.001) and presence of significant WMH with worse performance in global cognition (p=0.017), executive function (p=0.016), visuomotor speed (p<0.001) and memory (p=0.001) domains (Table-1). No association was observed between number of lacunes and cognitive decline.
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".