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May 20, 2015Cerebrovascular Diseases Extra42 citationsOpen Access

Cerebral Microbleeds and White Matter Hyperintensities in Cognitively Healthy Elderly: A Cross-Sectional Cohort Study Evaluating the Effect of Arterial Stiffness

AGAnna‐Märta GustavssonESErik StomrudKAKasim Abul‐Kasim

Key Result

Arterial stiffness was associated with white matter hyperintensities (OR 1.58; 95% CI 1.04-2.40), though attenuated by cardiovascular risk factors, and not with microbleeds or cognitive function.

Study Design

Type

Cross-Sectional (n=208)

Structured PICO

Does arterial stiffness influence the presence of cerebral microbleeds, white matter hyperintensities, and cognitive function in cognitively healthy elderly?

P
Population
208 cognitively healthy elderly individuals (mean age 72 years, 59% women) without cognitive impairment symptoms who underwent brain MRI and cognitive testing.
E
Exposure
Arterial stiffness measured with carotid-femoral pulse wave velocity (cfPWV)
O
Outcome
Presence of cerebral microbleeds, white matter hyperintensities (WMH) on brain MRI, and cognitive function (measured by 8 cognitive tests)surrogate

In cognitively healthy elderly individuals, arterial stiffness is not independently associated with cerebral microbleeds or cognitive function, and its association with white matter hyperintensities is attenuated by cardiovascular risk factors.

Main Result

Odds Ratio: 1.58 (95% CI 1.04–2.4)

p-value: p=< 0.05

Limitations

  • Longitudinal follow-up studies are needed to further assess the associations.
  • Cross-sectional design limits causal inference, requiring longitudinal follow-up studies

Abstract

BACKGROUND: Arterial stiffness reflects the ageing processes in the vascular system, and studies have shown an association between reduced cognitive function and cerebral small vessel disease. Small vessel disease can be visualized as white matter hyperintensities (WMH) and lacunar infarcts but also as cerebral microbleeds on brain magnetic resonance imaging (MRI). We aimed to investigate if arterial stiffness influences the presence of microbleeds, WMH and cognitive function in a population of cognitively healthy elderly. METHODS: The study population is part of the Swedish BioFinder study and consisted of 208 individuals without any symptoms of cognitive impairment, who scored >27 points on the Mini-Mental State Examination. The participants (mean age, 72 years; 59% women) underwent MRI of the brain with visual rating of microbleeds and WMH. Arterial stiffness was measured with carotid-femoral pulse wave velocity (cfPWV). Eight cognitive tests covering different cognitive domains were performed. RESULTS: Microbleeds were detected in 12% and WMH in 31% of the participants. Mean (±standard deviation, SD) cfPWV was 10.0 (±2.0) m/s. There was no association between the presence of microbleeds and arterial stiffness. There was a positive association between arterial stiffness and WMH independent of age or sex (odds ratio, 1.58; 95% confidence interval, 1.04-2.40, p 0.05). Cognitive performance was not associated with microbleeds, but individuals with WMH performed slightly worse than those without WMH on the Symbol Digit Modalities Test (mean ± SD, 35 ± 7.8 vs. 39 ± 8.1, p < 0.05). Linear regression revealed no direct associations between arterial stiffness and the results of the cognitive tests. CONCLUSIONS: Arterial stiffness was not associated with the presence of cerebral microbleeds or cognitive function in cognitively healthy elderly. However, arterial stiffness was related to the presence of WMH, but the association was attenuated when multiple adjustments were made. There was a weak negative association between WMH and performance in one specific test of attention. Longitudinal follow-up studies are needed to further assess the associations.

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Cite This Study

Gustavsson et al. (2015) conducted a cross-sectional in Cognitively healthy elderly (n=208). Arterial stiffness was evaluated on Presence of white matter hyperintensities (WMH) (OR 1.58, 95% CI 1.04-2.40, p=< 0.05). Arterial stiffness was associated with white matter hyperintensities (OR 1.58; 95% CI 1.04-2.40), though attenuated by cardiovascular risk factors, and not with microbleeds or cognitive function.

synapsesocial.com/papers/6a2011657110a651dc04f2f3https://doi.org/10.1159/000377710
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