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O4‐02‐06: Cerebral microbleeds and cognitive impairment in community‐dwelling elderly from Singapore
Author(s) -
Ikram Mohammad Kamran,
Hilal Saima,
Catinding Joseree,
Ting Eric,
Lee Annie,
Qiu Anqi,
Koay Way Inn,
Lim Ben,
Wong Tien Yin,
Chen Christopher,
Venketasubramanian N.
Publication year - 2012
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2012.05.1645
Subject(s) - dementia , medicine , odds ratio , montreal cognitive assessment , hyperintensity , logistic regression , cognition , confidence interval , magnetic resonance imaging , population , neuropsychology , cardiology , disease , psychiatry , radiology , environmental health
tiple regression analyses, adjusted for age at MRI and duration between MRI and death, were used to examine the association between crosssectional WMH volume obtained on the MRI most proximal to death, and several neuropathologic measures including: myelin pallor, arteriosclerosis, microvascular disease, small vessel infarcts, large vessel infarcts, atherosclerosis, neurofibrillary tangle (NFT) and neuritic plaque (NP) scores. Second, a mixed-effects model was used to examine the association between longitudinal trajectory of WMH accumulation over time and neuropathologic measures. Time interaction terms for scores of myelin pallor, arteriosclerosis, microvascular disease, small vessel infarcts, large vessel infarcts, and atherosclerosis, NFT and NP scores, and APOE-ε4 presence were included. Analysis was adjusted for duration of follow up and age at death. Results:Mean age at death was 94.54 (SD 5.45) years. Higher burdens of arteriosclerosis (P 1⁄4 0.0002), microvascular disease (0.006) and small vessel infarcts (0.01) were significantly associated with larger cross-sectional WMH volume. No significant associations were observed with other pathologic measures. In the mixed-effects model, higher burdens of arteriosclerosis (P 1⁄4 0.002) and NFT pathology (P 1⁄4 0.02) showed more WMH accumulation over time. Conclusions: These findings suggest that WMH burden observed on MRI scans in very old individuals reflects the degree of small vessel ischemic disease burden, which is best captured by measures of arteriosclerosis on autopsy. Additionally, tau pathology may play a role in the processes leading to accumulation of WMH volume.