Higher Degree of Carotid Artery Stenosis is Associated with Worse Cognition (S45.005)
Bibliographic record
Abstract
Objective: To test the hypothesis that severity of carotid stenosis is inversely correlated with cognitive measures. Background: Studies have suggested that ischemic stroke from carotid stenosis may lead to cognitive impairment. However, the relationship between the degree of carotid stenosis and cognition has not been established. Design/Methods: We performed a cross-sectional study across one health care system, assessing patients with carotid Duplex ultrasound and the Montreal Cognitive Assessment (MoCA) that were done within one year from 2018 to 2022. Carotid stenosis was defined using Doppler velocity parameters as <50% normal, 50–69% moderate, 70–99% high-grade, and occluded. Cognition was quantified using MoCA where cognitive impairment was defined as MoCA <18. Multivariable regression analyses were performed to evaluate the linear relationship between carotid stenosis parameters and MoCA, and the odds of cognitive impairment across severity of carotid stenosis. Interaction analyses by age and stroke were performed. Results: Of 1,172 patients included in the study, 73.0%, 16.8%, 8.4% and 1.8% had normal, moderate, high-grade, and occluded carotids. Mean age was 73±12 years, 41.5% were female, 17.1% had prior stroke. ICA/CCA ratio was inversely associated with MoCA scores (β-coefficient=−0.362, p=0.010). Mean MoCA decreased with increasing degree of carotid stenosis (normal=20.8, moderate=20.4, high-grade=19.4, occluded=18.7;trend-p=0.021). There was a dose-dependent relationship between degree of carotid stenosis and cognitive impairment: Adjusted odds of cognitive impairment were 1.31, 2.14, 2.73 across patients with moderate, high-grade and occluded carotids (trend-P=0.016). Interaction analyses showed that age modified the relationship between carotid stenosis and cognition (p=0.003) where the association was observed in patients age ≥65 years (aOR=3.04, p=0.001) but not in age<65 years (aOR=0.46, p=0.175). No interaction was observed with stroke. Conclusions: Our study showed an inverse relationship between degree of carotid stenosis and cognition, particularly in patients 65 years or older. Future trials may consider testing whether carotid revascularization may prevent further cognitive decline in selected populations. Disclosure: Dr. Lin has nothing to disclose. Mr. Mateti has nothing to disclose. Dr. Erben has nothing to disclose. Dr. Barrett has nothing to disclose. The institution of Dr. Taner has received research support from NIH. Dr. Brott has nothing to disclose. The institution of Dr. Meschia has received research support from NINDS. The institution of Dr. Meschia has received research support from NINDS.
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 | 0.000 | 0.001 |
| 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 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.012 | 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".