Intracranial stenosis predicts cognitive decline in a memory clinic cohort
Bibliographic record
Abstract
Abstract Background Intracranial stenosis (ICS) is associated with cognitive impairment and dementia. It is suggested that ICS significantly increases the risk of progression from mild cognitive impairment to dementia. However, data examining the effects of ICS on cognitive decline are lacking. Thus, we aimed to investigate the effect of ICS on cognitive scores over a period of three years in a memory clinic cohort. Methods Participants were recruited from the National University Hospital memory clinic in Singapore. Data was collected using a standardized questionnaire, physical examination and 3T MRI at baseline. ICS was defined as arterial narrowing that exceeded 50% of the luminal diameter in any of the intracranial vessels. Cognitive functioning was measured at baseline and annually for 3 years using the mini‐mental state examination, Montreal cognitive assessment (MoCA), and a detailed neuropsychological test battery that has been locally validated. Results 311 participants attended all three follow up visits. The mean age was 71.8 ± 7.8 years and 138 (44.4%) of participants were male. A total of 54 (17.4%) participants had intracranial stenosis. ICS modified the positive association between cognitive scores of two consecutive visits. Compared to persons with no ICS, persons with ICS showed a significant difference in association in MoCA (β [Yes]: 0.84 [95%CI: 0.79 ‐ 0.90] vs. β [No]: 0.91 [95%CI: 0.87 ‐ 0.95], p‐value = 0.007), global cognition (β [Yes]: 0.93 [95%CI: 0.88 ‐ 0.99] vs. β [No]: 1.00 [95%CI: 0.95 ‐ 1.04], p‐value = 0.037), executive function (β [Yes]: 0.85 [95%CI: 0.79 ‐ 0.90] vs. β [No]: 0.78 [95%CI: 0.74 ‐ 0.82], p‐value = 0.014), and memory (β [Yes]: 0.92 [95%CI: 0.87 ‐ 0.97] vs. β [No]: 0.98 [0.95 ‐ 1.00], p‐value = 0.016). These results remained significant after controlling for other risk factors and imaging markers. Conclusion ICS modified the positive association between cognitive scores of two consecutive visits where the association becomes less pronounced among persons with ICS for MoCA, global cognition and memory, but more pronounced for executive function. This suggests that ICS may be a useful indicator of vascular brain damage and may warrant consideration of anti‐atherosclerotic treatment in clinical trials.
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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 | 0.002 |
| 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 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".