Evidence map›Paper›PMID 40953349›Full record

Observational studyNeurology2025

Multimarker Cerebral Small Vessel Disease Score and Risk of Incident Dementia in the Framingham Heart Study.

Adlin Pinheiro, Oluchi Ekenze, Hugo J Aparicio, Alexa S Beiser, Charles S Decarli, Serkalem Demissie, Sudha Seshadri, Jose Rafael Romero

Abstract readObservational Study
In one paragraph

Observational study in Neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Adlin PinheiroDepartment of Biostatistics, Boston University School of Public Health, MA.ORCID 0000-0002-4241-9198
Oluchi EkenzeFramingham Heart Study, MA.ORCID 0000-0002-2510-8427
Hugo J AparicioFramingham Heart Study, MA.ORCID 0000-0001-8584-1455
Alexa S BeiserDepartment of Biostatistics, Boston University School of Public Health, MA.ORCID 0000-0001-8551-7778
Charles S DecarliDepartment of Neurology, University of California at Davis; and.ORCID 0000-0003-1914-2693
Serkalem DemissieDepartment of Biostatistics, Boston University School of Public Health, MA.ORCID 0000-0002-8009-0987
Sudha SeshadriThe Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio.ORCID 0000-0001-6135-2622
Jose Rafael RomeroFramingham Heart Study, MA.ORCID 0000-0002-1101-2950

Funding

FRAMINGHAM HEART STUDY - YEAR 5 EXAM75N92019D00031 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · 2019 to 2024
$29.8M
UC Davis Alzheimer's Disease Core CenterP30AG010129 · NIA · UNIVERSITY OF CALIFORNIA DAVIS · PI OLICHNEY, JOHN M · 1991 to 2020
$28.3M
PRECURSORS OF STROKE INCIDENCE AND PROGNOSISR01NS017950 · NINDS · UNIVERSITY OF TEXAS HLTH SCIENCE CENTER · PI Hugo Javier Aparicio, Jose Rafael Romero · 1985 to 2026
$22.9M
EPIDEMIOLOGY OF DEMENTIA IN THE FRAMINGHAM STUDYR01AG008122 · NIA · BOSTON UNIVERSITY MEDICAL CAMPUS · PI AU, RHODA, SESHADRI, SUDHA · 1989 to 2015
$14.4M
Temporal Trends, Novel Imaging and Molecular Characterization of Preclinical and Clinical Alzheimer's Disease in the Framingham CohortsR01AG054076 · NIA · UNIVERSITY OF TEXAS HLTH SCIENCE CENTER · PI DECARLI, CHARLES, SESHADRI, SUDHA · 2016 to 2020
$12.3M
Collaborative GWAS of Dementia, AD and related MRI and Cognitive EndophenotypesR01AG033193 · NIA · BOSTON UNIVERSITY MEDICAL CAMPUS · PI SESHADRI, SUDHA · 2009 to 2016
$4.4M
Enlarged Perivascular Spaces as Markers of Vascular and Alzheimer pathology: predictors, pathophysiology and clinical consequencesR01AG059725 · NIA · BOSTON UNIVERSITY MEDICAL CAMPUS · PI ROMERO, JOSE RAFAEL · 2019 to 2023
$3.1M
Risk Factors, Genetics and Cognition in Cerebral Microbleeds: Framingham StudyK23AG038444 · NIA · BOSTON UNIVERSITY MEDICAL CAMPUS · PI ROMERO, JOSE RAFAEL · 2011 to 2015
$644k
Longitudinal Risk Factor Changes and Early Recognition of Cerebral Small Vessel DiseaseR21NS135268 · NINDS · BOSTON UNIVERSITY MEDICAL CAMPUS · PI ROMERO, JOSE RAFAEL · 2023 to 2023
$454k
Cerebral Microbleeds in Young Adults: risk factors, biomarkers and geneticsR03AG048180 · NIA · BOSTON UNIVERSITY MEDICAL CAMPUS · PI ROMERO, JOSE RAFAEL · 2015 to 2016
$164k
THE FRAMINGHAM HEART STUDY-N01HC25195-268025195-268025195N01HC025195 · HC · TRUSTEES OF BOSTON UNIVERSITY · PI WOLF, PHILIP A · 2002 to 2006
–
NHLBI NIH HHS 75N92019D00031NHLBI NIH HHS N01 HC025195NIA NIH HHS K23 AG038444NIA NIH HHS P30 AG010129NIA NIH HHS R01 AG008122NIA NIH HHS R01 AG033193NIA NIH HHS R01 AG054076NIA NIH HHS R01 AG059725NIA NIH HHS R03 AG048180NINDS NIH HHS R01 NS017950NINDS NIH HHS R21 NS135268
6 · The paper itself

Abstract

BACKGROUND AND

objectivesIndividual MRI markers of cerebral small vessel disease (CSVD) are associated with impaired cognition and dementia but may not reflect the overall burden of CSVD. In addition, it is unclear whether these markers provide additional value in dementia risk assessment beyond vascular risk factors alone. Thus, we studied the association between the additive burden of multiple CSVD markers and incident dementia and determined whether this relationship remains independent of the Framingham Stroke Risk Profile (FSRP), a tool used commonly used for stroke risk prediction.

methodsA total of 1,152 MRI scans from participants in the Original and Offspring cohorts of the Framingham Heart Study, a large observational cohort study, were included. Participants were older than 55 years and free of prevalent dementia, stroke, or other neurologic conditions at the time of MRI. A multimarker score capturing CSVD burden was defined as the sum of CSVD features detected in the MRI: cerebral microbleeds, covert brain infarcts, extensive white matter hyperintensities, high-burden perivascular spaces, and cortical superficial siderosis. Multivariate Cox regression models examined the association between the multimarker CSVD score and incident all-cause dementia, Alzheimer dementia (AD), and vascular dementia.

resultsThe mean age was 70.9 years (SD 8.7) (527 [46%] were male), and 211 (18%) had a CSVD score of ≥2. Over a median follow-up time of 7.4 years (interquartile range 4.6-11.3), participants with a score ≥2 had significantly elevated risk of all-cause dementia compared with those with no CSVD markers after adjustment for the FSRP (hazard ratio [HR] 1.67; 95% CI 1.05-2.66) and vascular risk factors (HR 1.76; 95% CI 1.10-2.81). The multimarker CSVD score demonstrated similar model performance metrics to the FSRP (Harrell DISCUSSION: We found a significant association between all-cause dementia and multimarker CSVD scores, which was independent of the FSRP as well as its individual components. Our results support the use of a multimarker CSVD score as an indicator for incident all-cause dementia risk and suggest that it may be as robust as the FSRP. Further studies are necessary to validate the use of a multimarker CSVD score in dementia risk prediction.

Indexed as

Cerebral Small Vessel DiseasesDementiaAgedAged, 80 and overBiomarkersBrainCohort StudiesFemaleHumansIncidenceMagnetic Resonance ImagingMaleMiddle AgedRisk AssessmentRisk FactorsBiomarkers

Identifiers

PMID40953349
PMCPMC12443037

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.