Abstract
Cerebral microbleeds (CMB), suspected markers of hemorrhage-prone microangiopathy, are common in patients with cerebrovascular disease and in those with cognitive impairment. Their longitudinal relationship with cognitive decline and incident dementia in non-demented community-dwelling older individuals has been insufficiently examined. 302 adults aged 70–90 participating in the population-based Sydney Memory and Ageing Study underwent a susceptibility-weighted imaging (SWI) MRI sequence. The relationship of CMB with performance on neuropsychological tests was examined both cross-sectionally and longitudinally, over a mean of 4 years. The association with cases of incident dementia during this period was also examined. The prevalence of CMB was 20%. In cross-sectional analysis, after adjusting for demographics and vascular risk factors, there was a significant association between the presence of CMB and poorer executive function. CMB were not associated with global cognition or other cognitive domains. On longitudinal analysis, after adjusting for demographics and vascular risk factors, there was a greater decline in visuospatial ability in those with CMB compared to those without. The presence of CMB was not associated with increased progression to dementia. CMB are associated with impairments in specific cognitive domains: executive function and decline in visuospatial ability, independent of other markers of CVD including white matter hyperintensities. This suggests a direct contribution of CMB to cognitive impairment although no significant difference in incident dementia rates was observed.
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Acknowledgements
The authors thank all participants and their supporters in the Sydney Memory and Ageing Study (MAS), and the MAS research team.
Funding
This study was supported by the National Health and Medical Research Council (NHMRC) of Australia Program Grant (no. 350833) and Capacity Building Grant (no. 568940). Dr. Paradise was funded by an Australian National University/NHMRC NNIDR – DCRC Early Diagnosis and Prevention Shared Grant. Dr. Crawford and Dr. Kochan were supported by NHMRC Program Grant (no. 568969).
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Author Matt Paradise, author Adam Seruga, author John D. Crawford, author Joga Chaganti, author Anbupalam Thalamuthu, author Nicole A. Kochan, author Henry Brodaty, author Wei Wen and author Perminder S. Sachdev declare they have no conflict of interest.
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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, and the applicable revisions at the time of the investigation. Informed consent was obtained from all patients for being included in the study.
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Paradise, M., Seruga, A., Crawford, J.D. et al. The relationship of cerebral microbleeds to cognition and incident dementia in non-demented older individuals. Brain Imaging and Behavior 13, 750–761 (2019). https://doi.org/10.1007/s11682-018-9883-3
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DOI: https://doi.org/10.1007/s11682-018-9883-3