Cholinergic white matter hyperintensity volume, cognitive decline, and incident dementia in older adults
Bibliographic record
Abstract
Abstract Background White matter hyperintensities (WMHs) are frequently observed in the elderly and their severity tends to increase with age. Previous studies have revealed that WMHs are closely related to cognitive dysfunction. However, as inter‐individual variations and a clinicoradiological discrepancy exist, not all individuals with severe WMH burden experience worse cognitive performance. Furthermore, the location of WMHs appears to be a critical factor in the relationship between WMHs and cognitive function. Few studies take both volume and location of white matter hyperintensities (WMHs) into account to explore the association between WMH burden and cognitive impairment. We therefore investigated associations of cholinergic WMH volume (WMHV) with global cognitive function, cognitive decline, and incident dementia in older adults. Method A total of 752 older adults (mean age 60 years, 50% female) from the Taizhou Imaging Study were involved. Brain magnetic resonance imaging data at baseline and repeated measures of cognition over 5 years were collected and analyzed. WMHV in whole brain, the cholinergic pathways, and different tract classes in the Montreal Neurologic Institute standard space was obtained using the Lesion Segmentation Toolbox and tools from FMRIB Software Library. Multivariable linear regression, Cox regression, and partial correlation tests were performed. Result Over a median 5.67 (IQR: 2.88‐6.84) years of follow‐up, cholinergic WMHV was associated with annual decline of Mini‐Mental State Examination (MMSE) (β = ‐0.206; P = 0.006), and incident dementia (HR = 3.45; 95%CI: 2.08‐5.74). Within the cholinergic pathways, WMHs in commissural fibers were related to incident dementia. However, greater global WMHV only slightly increased the risk of incident dementia (HR = 1.03; 95%CI: 1.01‐1.06). Neither global nor cholinergic WMHV was associated with MMSE in cross‐sectional analysis. Conclusion Cholinergic WMHV is associated with longitudinal cognitive decline and incident dementia in older adults. Within the cholinergic pathways, commissural fiber tracts were strategic locations correlated to incident dementia. Our findings suggest cholinergic WMHV might be a potential indicator of cognitive deterioration.
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How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | medium |
| gpt | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | low |
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 | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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, unvalidatedLabeled directly by 2 models reading the full record.
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".