Cerebral microbleeds, retinopathy, and dementia
- 14 December 2010
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Neurology
- Vol. 75 (24), 2221-2228
- https://doi.org/10.1212/wnl.0b013e3182020349
Abstract
Objective: To determine whether microvascular damage, indicated by cerebral microbleeds (CMBs) and retinal microvascular signs, is associated with cognitive function and dementia in older persons. Methods: This is a cross-sectional study of 3,906 participants (mean age 76 years; 58% women) in the AGES-Reykjavik Study (2002–2006). We assessed CMBs on MRI and retinal microvascular signs on digital retinal images. Composite Z scores of memory, processing speed, and executive function were derived from a battery of neurocognitive tests. Dementia and subtypes were diagnosed following international criteria. Regression models were used to relate cognitive Z scores and dementia to CMBs and retinal microvascular signs, adjusting for demographics, cardiovascular factors, and brain ischemic lesions. Results: People with multiple (≥2) CMBs had lower Z scores on tests of processing speed (β-coefficient −0.16; 95% confidence interval −0.26 to −0.05) and executive function (−0.14; −0.24 to −0.04); results were strongest for having multiple CMBs located in the deep hemispheric or infratentorial areas. The odds ratio of vascular dementia was 2.32 (95% confidence interval 1.02 to 5.25) for multiple CMBs and 1.95 (1.04 to 3.62) for retinopathy. Having both CMBs and retinopathy, compared to having neither, was significantly associated with markedly slower processing speed (−0.25; −0.37 to −0.12), poorer executive function (−0.19; −0.31 to −0.07), and an increased odds ratio of vascular dementia (3.10; 1.11 to 8.62). Conclusion: Having multiple CMBs or concomitant CMBs and retinopathy is associated with a profile of vascular cognitive impairment. These findings suggest that microvascular damage, as indicated by CMBs and retinopathy lesions, has functional consequences in older men and women living in the community.This publication has 41 references indexed in Scilit:
- Diagnostic and Statistical Manual of Mental DisordersPsychiatry Research, 2011
- Correlation of hypointensities in susceptibility-weighted images to tissue histology in dementia patients with cerebral amyloid angiopathy: a postmortem MRI studyActa Neuropathologica, 2009
- Retinal microvascular abnormalities and cognitive declineNeurology, 2009
- Migraine Headache in Middle Age and Late-Life Brain InfarctsJama-Journal Of The American Medical Association, 2009
- Microvascular lesions in the brain and retina: The age, gene/environment susceptibility–Reykjavik studyAnnals of Neurology, 2009
- Cerebral Infarcts and Cognitive PerformanceStroke, 2009
- Cerebral microbleeds: a guide to detection and interpretationThe Lancet Neurology, 2009
- Effects of central arterial aging on the structure and function of the peripheral vasculature: implications for end-organ damageJournal of Applied Physiology, 2008
- Cognitive Impairment: An Increasingly Important Complication of Type 2 Diabetes: The Age, Gene/Environment Susceptibility-Reykjavik StudyAmerican Journal of Epidemiology, 2008
- Age, Gene/Environment Susceptibility-Reykjavik Study: Multidisciplinary Applied PhenomicsAmerican Journal of Epidemiology, 2007