Prevalence and risk factors of cerebral microbleeds: an update of the Rotterdam scan study.
OBJECTIVE
We previously reported on the high prevalence of cerebral microbleeds (CMBs) in community-dwelling people aged 60 years and older. Moreover, we found that their spatial distribution likely reflects differences in underlying etiology. We have since almost quadrupled the number of participants in our study and expanded it to include persons of 45 years and older. We examined the prevalence and determinants of microbleeds in this larger and younger cohort from the general population.


METHODS
In 3979 persons (mean age, 60.3 years), we performed brain MRI at 1.5T, including a sequence optimized for visualization of CMBs. Associations between APOE genotype, cardiovascular risk factors, and markers of cerebrovascular disease with the presence and location of CMBs were assessed by multiple logistic regression adjusted for age, sex, and relevant confounders.


RESULTS
Microbleed prevalence gradually increased with age, from 6.5% in persons aged 45 to 50 years to 35.7% in participants of 80 years and older. Overall, 15.3% of all subjects had at least 1 CMB. Cardiovascular risk factors and presence of lacunar infarcts and white matter lesions were associated with microbleeds in a deep or infratentorial region, whereas APOE ε4 and diastolic blood pressure were related to microbleeds in a strictly lobar location.


CONCLUSIONS
Findings in this larger population are in line with our previous results and, more importantly, extend these to a younger age group. CMBs are already present at middle age, and prevalence rises strongly with increasing age. We confirmed that determinants of the presence of cerebral microbleeds differ according to their location in the brain.
Poels
Mariëlle M F
MM
Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Vernooij
Meike W
MW
Ikram
M Arfan
MA
Hofman
Albert
A
Krestin
Gabriel P
GP
van der Lugt
Aad
A
Breteler
Monique M B
MM
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000098:blood supply* / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000453:epidemiology* / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012306:Risk; D012307:Risk Factors