Cerebral Microbleeds in Advanced Dementia: Clinical and Pathological Correlates

• Published in: American journal of Alzheimer's disease and other dementias Vol. 33; no. 6; pp. 362 - 372
• Main Authors: Boyano, Inmaculada, Ramos, Ana, López-Alvarez, Jorge, Mendoza-Rebolledo, Carolina, Osa-Ruiz, Emma, Rodríguez, Irene, Pérez, Almudena, Alfayate, Eva, González, Belén, Fernández, Laura, Agüera-Ortiz, Luis, Rábano, Alberto, Olazarán, Javier
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.09.2018
• Subjects: Aged, 80 and over; Alzheimer Disease - complications; Brain - diagnostic imaging; Cerebral Amyloid Angiopathy; Cerebral Hemorrhage - diagnostic imaging; Cerebral Hemorrhage - etiology; Current Topics in Research; Dementia - complications; Dementia - diagnostic imaging; Female; Humans; Longitudinal Studies; Magnetic Resonance Imaging; Male; Severity of Illness Index; dementia; cerebral microbleeds; cerebrovascular disease; Alzheimer’s disease; amyloid angiopathy
• ISSN: 1533-3175; 1938-2731
• DOI: 10.1177/1533317518770783

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.