Cerebral Microbleeds in Advanced Dementia: Clinical and Pathological Correlates

Objective: We conducted a longitudinal study to explore the clinical and pathological correlates of cerebral microbleeds (CMBs) in institutionalized patients with dementia. Methods: Clinical and magnetic resonance imaging (MRI) data were extracted from 182 nursing home patients (mean age [standard deviation]: 81.3 [6.9], 78.0% female, and 83.4% moderate to severe dementia), which were divided according to the CMBs number and location. One-year follow-up data were obtained from 153 patients, and postmortem pathological diagnosis was available in 40 patients. Results: Cerebral microbleeds were observed in 42.9% of patients and were associated with MRI ischemic lesions (P < .0005). In the adjusted analysis, lobar CMB predicted worsening of parkinsonism (standardized β: 0.43) and gait (standardized β: 0.24). A pathological diagnosis of Alzheimer’s disease was less frequent in the brains of patients with lobar and deep CMB (33.3% vs 85.3%; P < .05). Conclusion: Cerebral microbleeds were linked to cerebrovascular disease and predicted motor deterioration in institutionalized people with advanced dementia.