Covert Vascular Brain Injury and Cognitive Dysfunction Among Chinese Adults Living in Canada and China
Bibliographic record
Abstract
BACKGROUND AND OBJECTIVE: It is unclear whether variation in covert cerebrovascular disease prevalence is attributable to ethnic differences or to other factors. We aimed to examine the associations of country of residence with covert vascular brain injury (VBI) and cognitive dysfunction among Chinese adults residing in Canada and China. METHODS: This was a multisite cross-sectional study of Chinese adults aged 40-80 years in the Canadian Alliance for Healthy Hearts and Healthy Minds (CAHHM; January 1, 2014, to December 31, 2018) and Prospective Urban Rural Epidemiological-Mind (PURE-MIND; November 1, 2010, to July 31, 2015) cohorts living in Canada and China. The exposure was country of residence. The co-primary outcomes were covert VBI (defined as MRI findings of high white matter hyperintensities or covert brain infarct) and cognitive dysfunction (defined as a Montreal Cognitive Assessment [MoCA] score <26). We used generalized linear models to describe the association between country of residence and each outcome, adjusting for selected covariates. RESULTS: We included 884 adults living in Canada (mean age 57.3 years, 55.4% female) and 473 living in China (mean age 56.8 years, 60.3% female). Participants in Canada had a lower prevalence of covert VBI (age 65-79 years: male, 11.5%; female, 12.2%) than those living in China (age 65-79 years: male, 62.9%; female, 52.1%). Prevalence of MoCA score <26 was lower among men and women in Canada (age 65-79 years: 40.2% and 30.0%, respectively) than among men and women in China (age 65-79 years: 74.3% and 79.2%). Living in China was associated with a 6-fold increase in the odds of covert VBI (5.85, 4.06-8.45), which remained significant after covariate adjustment. Living in China was associated with a 7-fold increase in the odds of MoCA score <26 (6.98, 5.38-9.04), which was no longer significant after covariate adjustment. DISCUSSION: Despite sharing a similar ethnicity, the prevalence of covert VBI and cognitive dysfunction varied substantially by country of residence. Disparities in cognitive dysfunction were completely explained by differences in education and traditional cerebrovascular risk factors, whereas disparities in covert VBI prevalence were only partially explained by differences in such factors, suggesting a role for other environmental factors.
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 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| 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".