Cerebral small vessel disease and the risk of dementia: A systematic review and meta-analysis of population-based evidence

doi:10.1016/j.jalz.2018.04.007

Review

. 2018 Nov;14(11):1482-1492.

doi: 10.1016/j.jalz.2018.04.007. Epub 2018 May 21.

Cerebral small vessel disease and the risk of dementia: A systematic review and meta-analysis of population-based evidence

Daniel Bos¹, Frank J Wolters², Sirwan K L Darweesh², Meike W Vernooij³, Frank de Wolf⁴, M Arfan Ikram⁵, Albert Hofman⁶

Affiliations

¹ Department of Radiology and Nuclear Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
² Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
³ Department of Radiology and Nuclear Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands.
⁴ Janssen Prevention Center, Leiden, The Netherlands; Faculty of Medicine, School of Public Health, Imperial College London, London, UK.
⁵ Department of Radiology and Nuclear Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Neurology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands.
⁶ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Electronic address: ahofman@hsph.harvard.edu.

PMID: 29792871
DOI: 10.1016/j.jalz.2018.04.007

Review

Cerebral small vessel disease and the risk of dementia: A systematic review and meta-analysis of population-based evidence

Daniel Bos et al. Alzheimers Dement. 2018 Nov.

. 2018 Nov;14(11):1482-1492.

doi: 10.1016/j.jalz.2018.04.007. Epub 2018 May 21.

Authors

Daniel Bos¹, Frank J Wolters², Sirwan K L Darweesh², Meike W Vernooij³, Frank de Wolf⁴, M Arfan Ikram⁵, Albert Hofman⁶

Affiliations

¹ Department of Radiology and Nuclear Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
² Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
³ Department of Radiology and Nuclear Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands.
⁴ Janssen Prevention Center, Leiden, The Netherlands; Faculty of Medicine, School of Public Health, Imperial College London, London, UK.
⁵ Department of Radiology and Nuclear Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Neurology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands.
⁶ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Electronic address: ahofman@hsph.harvard.edu.

PMID: 29792871
DOI: 10.1016/j.jalz.2018.04.007

Abstract

Introduction: Cerebral small vessel disease is increasingly linked to dementia.

Methods: We systematically searched Medline, Embase, and Cochrane databases for prospective population-based studies addressing associations of white matter hyperintensities, covert brain infarcts (i.e., clinically silent infarcts), and cerebral microbleeds with risk of all-dementia or Alzheimer's disease and performed meta-analyses.

Results: We identified 11 studies on white matter hyperintensities, covert brain infarcts, or cerebral microbleeds with risk of all-dementia or Alzheimer's disease. Pooled analyses showed an association of white matter hyperintensity volume and a borderline association of covert brain infarcts with risk of all-dementia (hazard ratio: 1.39 [95% confidence interval: 1.00; 1.94], N = 3913, and 1.47 [95% confidence interval: 0.97; 2.22], N = 8296). Microbleeds were not statistically significantly associated with an increased risk of all-dementia (hazard ratio: 1.25 [95% confidence interval: 0.66; 2.38], N = 8739).

Discussion: White matter hyperintensities are associated with an increased risk of all-dementia and Alzheimer's disease in the general population. However, studies are warranted to further determine the role of markers of cerebral small vessel disease in dementia.

Keywords: Cerebral small vessel disease; Covert brain infarcts; Dementia; Imaging; Microbleeds; White matter hyperintensities.

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Cerebral small vessel disease and the risk of dementia: A systematic review and meta-analysis of population-based evidence

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Cerebral small vessel disease and the risk of dementia: A systematic review and meta-analysis of population-based evidence

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