Markers of left atrial cardiopathy for the prediction of dementia risk in aging adults: An analysis of Cardiovascular Health Study
Bibliographic record
Abstract
Abstract Background Atrial fibrillation (AF) is the most common cardiac arrhythmia. Several population‐based studies report associations between AF and dementia. Clinical AF is often preceded by substantive atrial structural and electrical remodeling, termed atrial cardiopathy and prior studies have shown that atrial cardiopathy is independently associated with dementia in the absence of AF. This study aims to develop and validate a prediction model for dementia risk using markers of atrial in addition to traditional vascular risk factors (i.e., CHA 2 DS 2 ‐VASc). Method This study utilized data from the Cardiovascular Health Study (CHS). A cohort of 3,608 participants who completed magnetic resonance imaging (MRI) and cognitive testing during 1992‐1994 were included for analysis. Markers of left atrial cardiopathy included left atrial dimension, p ‐wave terminal in lead V1 (PTFV1), and N‐Terminal pro‐Brain Natriuretic Peptide (NT‐pro BNP) level, all previously shown to be associated with left atrial function. Prediction models were built to estimate the predictive accuracy of combining markers of atrial cardiopathy with traditional clinical risk variables (CHA2DS2‐VASc) for dementia risk, in accordance with TRIPOD (Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis) prediction model recommendations. Result During a mean follow‐up of 7.6 years, 322 participants had incident dementia. Individuals with higher NT‐pro BNP levels had significantly higher cumulative incidence rates for incident dementia. Compared to the reference model, continuous PTFV1 and NT‐pro BNP level in both the categorical scale and log scale improved model fit for incident dementia in females. Compared to the reference model (CHA2DS2‐VASc), continuous NT‐pro BNP level improved model fit in males. Conclusion NT‐pro BNP, an emerging indicator of atrial cardiopathy, improves dementia risk prediction model fit compared to that obtained using the CHA2DS2‐VASc score. These findings have implications for dementia risk prediction and the development of screening tools for dementia prevention before the onset of clinical AF.
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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 | 0.004 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.003 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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, 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".