{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:49:58Z","timestamp":1790254198560,"version":"4.1.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T00:00:00Z","timestamp":1765584000000},"content-version":"vor","delay-in-days":103,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100010969","name":"Alzheimer Nederland","doi-asserted-by":"crossref","award":["WE 15-2021-05"],"award-info":[{"award-number":["WE 15-2021-05"]}],"id":[{"id":"10.13039\/501100010969","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Stroke Association and Chief Scientist Office of Scotland","award":["PPA 2015\/01_CSO"],"award-info":[{"award-number":["PPA 2015\/01_CSO"]}]},{"DOI":"10.13039\/501100010969","name":"Alzheimer Nederland","doi-asserted-by":"publisher","award":["WE 15-2021-05"],"award-info":[{"award-number":["WE 15-2021-05"]}],"id":[{"id":"10.13039\/501100010969","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Stroke Association and Chief Scientist Office of Scotland","award":["PPA 2015\/01_CSO"],"award-info":[{"award-number":["PPA 2015\/01_CSO"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>A better understanding of who will develop dementia can inform patient care. Although MRI offers prognostic insights, access is limited globally, whereas CT-imaging is readily available in acute stroke. We explored the prognostic utility of acute CT-imaging for predicting dementia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>We included stroke or transient ischaemic attack (TIA) survivors from participating stroke centres in Scotland. Acute CT-scans were rated using ordinal scales for neurodegenerative and cerebrovascular changes (old infarcts, white matter lesions (WMLs), medial temporal lobe atrophy (MTA), and global atrophy (GA)) and combined together to a \u2018brain-frailty\u2019 score. Dementia status was established at 18-months following stroke or TIA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 195 participants, 33% had dementia after 3\u2009years of follow-up. High brain-frailty score (\u2a7e2\/4) correlated with higher risk of dementia (HR (95% CI) 6.02\u2009(1.89\u201319.21)). As individual predictor, severe MTA was most strongly associated with dementia (adjusted HR (95% CI) 2.09\u2009(1.07\u20134.08)). Other predictors associated with dementia included older age, higher prestroke morbidity (mRS), WMLs, and GA. Integrated in a prediction model with clinical parameters, prestroke mRS, cardiovascular disease, GA, MTA and Abbreviated-Mental-Test were the strongest predictors of dementia (c-statistic: 0.77).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and conclusion<\/jats:title>\n                    <jats:p>Increased brain-frailty, and its individual components (WMLs, MTA, and GA) are associated with a higher risk of dementia in participants with stroke. Combining clinical and brain-frailty parameters created a moderate dementia prediction model but added little value over clinical parameters in combination with cognitive testing. CT-based brain-frailty may provide better prognostic insights when cognitive testing isn\u2019t feasible and for identifying highest-risk individuals for dementia prevention trials to increase trial efficiency.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23969873251325076","type":"journal-article","created":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T05:41:57Z","timestamp":1741844517000},"page":"978-987","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Prediction of dementia using CT imaging in stroke (PRODUCTS)"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0972-8615","authenticated-orcid":false,"given":"Melanie","family":"Hafdi","sequence":"first","affiliation":[{"name":"Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3027-5369","authenticated-orcid":false,"given":"Martin","family":"Taylor-Rowan","sequence":"additional","affiliation":[{"name":"Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK 2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bogna","family":"Drozdowska","sequence":"additional","affiliation":[{"name":"Cumming School of Medicine, University of Calgary, Calgary, Canada 3"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4323-9308","authenticated-orcid":false,"given":"Emma","family":"Elliott","sequence":"additional","affiliation":[{"name":"National Institute for Health and Care Research (NIHR) Applied Research Collaboration Greater Manchester, School of Health Sciences, The University of Manchester, Manchester, UK 4"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7625-4504","authenticated-orcid":false,"given":"Lucy","family":"McGuire","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular and Metabolic Sciences, University of Glasgow, Glasgow, UK 5"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edo","family":"Richard","sequence":"additional","affiliation":[{"name":"Department of Neurology, Donders Institute for Brain, Behaviour and Cognition, Radboud University Medical Centre, Nijmegen, The Netherlands 6"},{"name":"Department of Public & Occupational Health, University of Amsterdam, Amsterdam, The Netherlands 7"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1401-0181","authenticated-orcid":false,"given":"Terence J","family":"Quinn","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular and Metabolic Sciences, University of Glasgow, Glasgow, UK 5"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,9,1]]},"reference":[{"key":"2026012115063610100_bibr1-23969873251325076","doi-asserted-by":"crossref","first-page":"1859","DOI":"10.1016\/S0140-6736(18)32335-3","article-title":"Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990\u20132017: a systematic analysis for the global burden of disease study 2017","volume":"392","author":"Kyu","year":"2018","journal-title":"Lancet"},{"key":"2026012115063610100_bibr2-23969873251325076","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1001\/jamaneurol.2021.4346","article-title":"Twenty-year change in severity and outcome of ischemic and hemorrhagic strokes","volume":"79","author":"Toyoda","year":"2022","journal-title":"JAMA 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