Multiple or mixed cerebral microbleeds and dementia in patients with vascular risk factors

OBJECTIVE:To investigate whether cerebral microbleeds (CMBs) are independently associated with incident dementia in patients with vascular risk factors. METHODS:Using data from a Japanese cohort of participants with vascular risk factors in an observational study from 2001, we evaluated the associat...

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Veröffentlicht in:Neurology 2014-08, Vol.83 (7), p.646-653
Hauptverfasser: Miwa, Kaori, Tanaka, Makiko, Okazaki, Shuhei, Yagita, Yoshiki, Sakaguchi, Manabu, Mochizuki, Hideki, Kitagawa, Kazuo
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container_end_page 653
container_issue 7
container_start_page 646
container_title Neurology
container_volume 83
creator Miwa, Kaori
Tanaka, Makiko
Okazaki, Shuhei
Yagita, Yoshiki
Sakaguchi, Manabu
Mochizuki, Hideki
Kitagawa, Kazuo
description OBJECTIVE:To investigate whether cerebral microbleeds (CMBs) are independently associated with incident dementia in patients with vascular risk factors. METHODS:Using data from a Japanese cohort of participants with vascular risk factors in an observational study from 2001, we evaluated the association between CMBs at baseline and incident dementia. Baseline brain MRI was used to determine small-vessel disease (CMBs, lacunar infarcts, and white matter hyperintensities) and brain atrophy. Cox proportional hazards analyses were performed for predictors of dementia adjusting for age, sex, APOE ε4 allele, educational level, baseline Mini-Mental State Examination score, cerebrovascular events, vascular risk factors, and MRI findings. RESULTS:Of the 524 subjects (mean age 68 ± 8.3 years, 57.6% male, 12.8 ± 2.6 years of schooling, 21.6% CMBs), 44 patients with incident dementia (20 Alzheimer disease, 18 vascular dementia, 3 mixed-type, and 3 other) were diagnosed during the median 7.5-year follow-up. In multivariate analysis, the presence of overall CMBs was not associated with an increased risk of incident all-cause dementia (p = 0.15). However, multiple CMBs (≥2) or mixed (lobar and deep) CMBs were associated with the increased risk of all-cause dementia, whereas strictly lobar CMBs showed no association with any dementia. CONCLUSIONS:Multiple CMBs or mixed CMBs independently showed higher risk of all-cause dementia. Our results reinforce the hypothesis that CMBs exert deleterious effects on dementia incidence, suggesting that this association may be mediated by vascular burden.
doi_str_mv 10.1212/WNL.0000000000000692
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METHODS:Using data from a Japanese cohort of participants with vascular risk factors in an observational study from 2001, we evaluated the association between CMBs at baseline and incident dementia. Baseline brain MRI was used to determine small-vessel disease (CMBs, lacunar infarcts, and white matter hyperintensities) and brain atrophy. Cox proportional hazards analyses were performed for predictors of dementia adjusting for age, sex, APOE ε4 allele, educational level, baseline Mini-Mental State Examination score, cerebrovascular events, vascular risk factors, and MRI findings. RESULTS:Of the 524 subjects (mean age 68 ± 8.3 years, 57.6% male, 12.8 ± 2.6 years of schooling, 21.6% CMBs), 44 patients with incident dementia (20 Alzheimer disease, 18 vascular dementia, 3 mixed-type, and 3 other) were diagnosed during the median 7.5-year follow-up. In multivariate analysis, the presence of overall CMBs was not associated with an increased risk of incident all-cause dementia (p = 0.15). However, multiple CMBs (≥2) or mixed (lobar and deep) CMBs were associated with the increased risk of all-cause dementia, whereas strictly lobar CMBs showed no association with any dementia. CONCLUSIONS:Multiple CMBs or mixed CMBs independently showed higher risk of all-cause dementia. Our results reinforce the hypothesis that CMBs exert deleterious effects on dementia incidence, suggesting that this association may be mediated by vascular burden.</description><identifier>ISSN: 0028-3878</identifier><identifier>EISSN: 1526-632X</identifier><identifier>DOI: 10.1212/WNL.0000000000000692</identifier><identifier>PMID: 25015364</identifier><identifier>CODEN: NEURAI</identifier><language>eng</language><publisher>Hagerstown, MD: American Academy of Neurology</publisher><subject>Aged ; Biological and medical sciences ; Brain - pathology ; Cerebral Hemorrhage - epidemiology ; Cerebral Hemorrhage - pathology ; Dementia - epidemiology ; Dementia - pathology ; Female ; Follow-Up Studies ; Humans ; Japan - epidemiology ; Kaplan-Meier Estimate ; Magnetic Resonance Imaging ; Male ; Medical sciences ; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. 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METHODS:Using data from a Japanese cohort of participants with vascular risk factors in an observational study from 2001, we evaluated the association between CMBs at baseline and incident dementia. Baseline brain MRI was used to determine small-vessel disease (CMBs, lacunar infarcts, and white matter hyperintensities) and brain atrophy. Cox proportional hazards analyses were performed for predictors of dementia adjusting for age, sex, APOE ε4 allele, educational level, baseline Mini-Mental State Examination score, cerebrovascular events, vascular risk factors, and MRI findings. RESULTS:Of the 524 subjects (mean age 68 ± 8.3 years, 57.6% male, 12.8 ± 2.6 years of schooling, 21.6% CMBs), 44 patients with incident dementia (20 Alzheimer disease, 18 vascular dementia, 3 mixed-type, and 3 other) were diagnosed during the median 7.5-year follow-up. In multivariate analysis, the presence of overall CMBs was not associated with an increased risk of incident all-cause dementia (p = 0.15). However, multiple CMBs (≥2) or mixed (lobar and deep) CMBs were associated with the increased risk of all-cause dementia, whereas strictly lobar CMBs showed no association with any dementia. CONCLUSIONS:Multiple CMBs or mixed CMBs independently showed higher risk of all-cause dementia. 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Leukoencephalitis</subject><subject>Multivariate Analysis</subject><subject>Neurology</subject><subject>Proportional Hazards Models</subject><subject>Risk Factors</subject><subject>Vascular Diseases - epidemiology</subject><subject>Vascular Diseases - pathology</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0028-3878</issn><issn>1526-632X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU2P0zAQhi0Eot3CP0DIFyQuKf6OfUTVLiCV5bIIxCWynYlq6iTFTujy7_Gq5UMc2Ll4Rn5mxn5fhJ5RsqaMslefrrdr8ncowx6gJZVMVYqzzw_RkhCmK65rvUAXOX8lpFzW5jFaMFlSrsQSfXk_xykcIuAx4T7cQos9JHDJxlL6NLoI0GZshxa30MMwBYvDgA92CqXI-BimHf5us5-jTTiFvMed9dOY8hP0qLMxw9PzuUIfry5vNm-r7Yc37zavt5UX1LCqddII7S0VjhlvjORaSUeMYIQazbTmDlTrvCVGtkQR4TrGqVASjHTCar5CL09zD2n8NkOemj5kDzHaAcY5N1SJmpQfS3Y_KiWnREglCypOaNEg5wRdc0iht-lHQ0lzZ0BTDGj-NaC0PT9vmF0P7e-mX4oX4MUZKJrZ2CU7-JD_cLrmxmhaOH3ijmOcIOV9nI-Qmh3YOO3-_4afwcmduA</recordid><startdate>20140812</startdate><enddate>20140812</enddate><creator>Miwa, Kaori</creator><creator>Tanaka, Makiko</creator><creator>Okazaki, Shuhei</creator><creator>Yagita, Yoshiki</creator><creator>Sakaguchi, Manabu</creator><creator>Mochizuki, Hideki</creator><creator>Kitagawa, Kazuo</creator><general>American Academy of Neurology</general><general>Lippincott Williams &amp; Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7TK</scope></search><sort><creationdate>20140812</creationdate><title>Multiple or mixed cerebral microbleeds and dementia in patients with vascular risk factors</title><author>Miwa, Kaori ; Tanaka, Makiko ; Okazaki, Shuhei ; Yagita, Yoshiki ; Sakaguchi, Manabu ; Mochizuki, Hideki ; Kitagawa, Kazuo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4192-db5948ca14b29c9953865b094201982883be6dbca095d0604bf231465e95b4a83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Brain - pathology</topic><topic>Cerebral Hemorrhage - epidemiology</topic><topic>Cerebral Hemorrhage - pathology</topic><topic>Dementia - epidemiology</topic><topic>Dementia - pathology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Japan - epidemiology</topic><topic>Kaplan-Meier Estimate</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis</topic><topic>Multivariate Analysis</topic><topic>Neurology</topic><topic>Proportional Hazards Models</topic><topic>Risk Factors</topic><topic>Vascular Diseases - epidemiology</topic><topic>Vascular Diseases - pathology</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Miwa, Kaori</creatorcontrib><creatorcontrib>Tanaka, Makiko</creatorcontrib><creatorcontrib>Okazaki, Shuhei</creatorcontrib><creatorcontrib>Yagita, Yoshiki</creatorcontrib><creatorcontrib>Sakaguchi, Manabu</creatorcontrib><creatorcontrib>Mochizuki, Hideki</creatorcontrib><creatorcontrib>Kitagawa, Kazuo</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Neurosciences Abstracts</collection><jtitle>Neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Miwa, Kaori</au><au>Tanaka, Makiko</au><au>Okazaki, Shuhei</au><au>Yagita, Yoshiki</au><au>Sakaguchi, Manabu</au><au>Mochizuki, Hideki</au><au>Kitagawa, Kazuo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multiple or mixed cerebral microbleeds and dementia in patients with vascular risk factors</atitle><jtitle>Neurology</jtitle><addtitle>Neurology</addtitle><date>2014-08-12</date><risdate>2014</risdate><volume>83</volume><issue>7</issue><spage>646</spage><epage>653</epage><pages>646-653</pages><issn>0028-3878</issn><eissn>1526-632X</eissn><coden>NEURAI</coden><abstract>OBJECTIVE:To investigate whether cerebral microbleeds (CMBs) are independently associated with incident dementia in patients with vascular risk factors. METHODS:Using data from a Japanese cohort of participants with vascular risk factors in an observational study from 2001, we evaluated the association between CMBs at baseline and incident dementia. Baseline brain MRI was used to determine small-vessel disease (CMBs, lacunar infarcts, and white matter hyperintensities) and brain atrophy. Cox proportional hazards analyses were performed for predictors of dementia adjusting for age, sex, APOE ε4 allele, educational level, baseline Mini-Mental State Examination score, cerebrovascular events, vascular risk factors, and MRI findings. RESULTS:Of the 524 subjects (mean age 68 ± 8.3 years, 57.6% male, 12.8 ± 2.6 years of schooling, 21.6% CMBs), 44 patients with incident dementia (20 Alzheimer disease, 18 vascular dementia, 3 mixed-type, and 3 other) were diagnosed during the median 7.5-year follow-up. In multivariate analysis, the presence of overall CMBs was not associated with an increased risk of incident all-cause dementia (p = 0.15). However, multiple CMBs (≥2) or mixed (lobar and deep) CMBs were associated with the increased risk of all-cause dementia, whereas strictly lobar CMBs showed no association with any dementia. CONCLUSIONS:Multiple CMBs or mixed CMBs independently showed higher risk of all-cause dementia. Our results reinforce the hypothesis that CMBs exert deleterious effects on dementia incidence, suggesting that this association may be mediated by vascular burden.</abstract><cop>Hagerstown, MD</cop><pub>American Academy of Neurology</pub><pmid>25015364</pmid><doi>10.1212/WNL.0000000000000692</doi><tpages>8</tpages></addata></record>
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source MEDLINE; Journals@Ovid Complete; Alma/SFX Local Collection
subjects Aged
Biological and medical sciences
Brain - pathology
Cerebral Hemorrhage - epidemiology
Cerebral Hemorrhage - pathology
Dementia - epidemiology
Dementia - pathology
Female
Follow-Up Studies
Humans
Japan - epidemiology
Kaplan-Meier Estimate
Magnetic Resonance Imaging
Male
Medical sciences
Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis
Multivariate Analysis
Neurology
Proportional Hazards Models
Risk Factors
Vascular Diseases - epidemiology
Vascular Diseases - pathology
Vascular diseases and vascular malformations of the nervous system
title Multiple or mixed cerebral microbleeds and dementia in patients with vascular risk factors
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