P2–166: Cerebral microbleeds and the risk of mortality in the general population

Akoudad, Saloua; Ikram, Mohammad; Koudstaal, Peter J.; Hofman, Albert; Lugt, Aad van der; Vernooij, Meike W.

doi:10.1016/j.jalz.2013.05.811

Cited by 2 publications

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“…4 CMB may reflect an aggregate measure of vascular disease burden and their detection may portend higher risk of mortality. 5 We investigated the association between CMB and mortality in a large sample of neurologically healthy persons dwelling in the community, accounting for vascular risk factors, preventive cardiovascular medication use, and ischemic brain MRI measures of CSVD.…”

Section: Introductionmentioning

confidence: 99%

Cerebral Microbleeds as Predictors of Mortality

Romero

Preis

Beiser

et al. 2017

Stroke

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Background and purpose Cerebral microbleeds (CMB) represent a common MRI marker of cerebral small vessel disease, increasingly recognized as a subclinical marker of stroke- and dementia- risk. CMB detection may reflect the cumulative effect of vascular risk burden and be a marker of higher mortality. We investigated the relation of CMB to risk of death in community dwelling participants free of stroke and dementia. Methods We evaluated 1963 Framingham Original and Offspring Cohort participants (mean age 67 years; 54% women) with available brain MRI and mortality data. Using Cox-proportional hazards models we related CMB to all-cause, cardiovascular and stroke-related mortality. Results Participants with CMB (8.9%) had higher prevalence of cardiovascular risk factors and use of preventive medications. During a mean follow up of 7.2±2.6 years we observed 296 deaths. In age and sex-adjusted analysis CMB were associated with increased all-cause mortality (hazards ratio [HR]=1.39, 95% CI 1.03–1.88), a relation that was no longer significant after adjustment for cardiovascular risk and preventive medication use (HR=1.15,95% CI 0.82–1.63). Conclusions CMBs may represent the deleterious effect of cardiovascular risk factors in the cerebral vasculature. While their presence was associated with increased all-cause mortality, the effect was no longer present after accounting for vascular risk factors and preventive treatment use. Further studies are required to clarify the role of cardiovascular preventive therapies for prevention of mortality in persons with incidental detection of CMB.

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Section: Introductionmentioning

confidence: 99%

Cerebral Microbleeds as Predictors of Mortality

Romero

Preis

Beiser

et al. 2017

Stroke

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“…(Akoudad et al, 2016) CMB are associated with stroke,(Charidimou et al, 2013, Chen et al, 2008, Fan et al, 2003, Wardlaw et al, 2006) poor cognition(Charidimou and Werring, 2012, Cordonnier et al, 2006, Poels et al, 2012, Werring et al, 2004, Yakushiji et al, 2008) and mortality risk. (Akoudad et al, 2013, Benedictus et al, 2015) CMBs represent the most common forms of hemorrhage-prone cerebral small vessel disease in the elderly and in persons with dementia: hypertensive arteriopathy and/or cerebral amyloid angiopathy based on their brain location. (Jansen et al, 2015) Autopsy studies have reported presence of hypertensive arteriopathy (arteriolosclerosis) in 10% of elderly persons and in 35% of AD patients,(Toledo et al, 2013) and CAA in 10 to 30% of elderly persons and 80 to 90% of all persons with dementia (25 to 41% moderate to severe CAA).…”

Section: Introductionmentioning

confidence: 99%

Cerebral microbleeds and risk of incident dementia: the Framingham Heart Study

Romero

Beiser

Himali

et al. 2017

Neurobiology of Aging

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Cerebral microbleeds (CMB) are MRI markers attributed to the most common cerebral angiopathies in the elderly and in patients with dementia: hypertensive and cerebral amyloid angiopathy (CAA). CMB detection in asymptomatic persons may help identify those at risk for dementia, and may influence preventive strategies and design of clinical trials testing treatments for dementia. We studied the association of CMB with risk of incident dementia in community dwelling individuals. 1296 dementia-free Framingham Heart Study participants (mean age 72years; 54% women) with available brain MRI and incident dementia data during a mean follow-up period of 6.7 years were included. Using Cox-proportional hazards models we related CMB presence to incident dementia. Multivariable models were adjusted for age, sex, APOE status, and education, with additional models adjusting for vascular risk factors and MRI markers of ischemic brain injury. CMB were observed in 10.8% and incident dementia in 85 participants (6.6% over study period). Participants with any CMB had 1.74 times higher risk of dementia (HR 1.74, 95% CI 1.00–3.01), while those with deep and mixed CMB had a three-fold increased risk (HR 2.99, 95% CI 1.52–5.90). The associations were independent of vascular risk factors, and for deep and mixed CMB also independent of MRI markers of ischemia (HR 2.44, 95% CI 1.22–4.88). Purely lobar CMB were not associated with incident dementia. Our findings support a role for hypertensive vasculopathy and the interplay of hypertensive and CAA in risk of dementia, and suggest that CMB presence can identify individuals at risk of dementia.

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P2–166: Cerebral microbleeds and the risk of mortality in the general population

Cited by 2 publications

References 0 publications

Cerebral Microbleeds as Predictors of Mortality

Cerebral Microbleeds as Predictors of Mortality

Cerebral microbleeds and risk of incident dementia: the Framingham Heart Study

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