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Cerebral microbleeds in a multiethnic elderly community: Demographic and clinical correlates

  • Anne F. Wiegman
    Affiliations
    Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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  • Irene B. Meier
    Affiliations
    Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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  • Nicole Schupf
    Affiliations
    Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA

    G.H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA

    Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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  • Jennifer J. Manly
    Affiliations
    Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA

    G.H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA

    Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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  • Vanessa A. Guzman
    Affiliations
    Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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  • Atul Narkhede
    Affiliations
    Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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  • Yaakov Stern
    Affiliations
    Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA

    G.H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA

    Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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  • Sergi Martinez-Ramirez
    Affiliations
    Massachusetts General Hospital, Stroke Research Center, Boston, MA, USA
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  • Anand Viswanathan
    Affiliations
    Massachusetts General Hospital, Stroke Research Center, Boston, MA, USA
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  • José A. Luchsinger
    Affiliations
    Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA

    Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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  • Steven M. Greenberg
    Affiliations
    Massachusetts General Hospital, Stroke Research Center, Boston, MA, USA
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  • Richard Mayeux
    Affiliations
    Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA

    G.H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA

    Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA

    Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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  • Adam M. Brickman
    Correspondence
    Corresponding author at: Taub Institute for Research on Alzheimer's Disease and the Aging Brain, PS Box 16, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY 10032, USA. Tel.: +1 212 342 1348; fax: +1 212 342 1838.
    Affiliations
    Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA

    G.H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA

    Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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      Highlights

      • We examine MRI cerebral microbleeds in a large multi-ethnic cohort of older adults.
      • Twenty-seven percent of participants had detectable microbleeds.
      • Deep and lobar microbleeds were associated with vascular risk and cerebrovascular disease.

      Abstract

      Background

      Microbleeds, small perivascular collections of hemosiderin manifested radiologically as hypointensities on gradient-echo magnetic resonance imaging (MRI), are important markers of small vessel pathology. Despite their clinical relevance, little is known about their prevalence and demographic correlates, particularly among ethnically diverse older adults. We examined demographic and clinical correlates of regional microbleeds in a multi-ethnic cohort and examined categorization schemes of microbleed distribution and severity.

      Methods

      Between 2005 and 2007, 769 individuals participated in a MRI study as part of the Washington Heights/Inwood Columbia Aging Project. Approximately four years later, 243 out of 339 participants (mean age = 84.50) who returned for a repeat MRI had gradient-echo scans for microbleed assessment and comprised the sample. We examined the association of deep and lobar microbleeds with age, sex, education, vascular factors, cognitive status and markers of small vessel disease.

      Results

      Sixty-seven of the 243 (27%) participants had at least one microbleed. Individuals with microbleeds were more likely to have a history of stroke than individuals without. When categorized as having either no microbleeds, microbleeds in deep regions only, in lobar regions only, and both deep and lobar microbleeds, hypertension, proportion of strokes, and white matter hyperintensity volume (WMH) increased monotonically across the four groups. The number of lobar microbleeds correlated with WMH volume and diastolic blood pressure.

      Conclusions

      Microbleeds in deep and lobar locations are associated with worse outcomes than microbleeds in either location alone, although the presence of lobar microbleeds appears to be more clinically relevant.

      Keywords

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