title: Cerebral microbleeds are associated with worse cognitive function: the Rotterdam Scan Study.
abstract: OBJECTIVE
  Cerebral microbleeds are frequently found in the general elderly population and may reflect underlying vascular disease, but their role in cognitive function is unknown.
  
  
  METHODS
  We investigated the association between cerebral microbleeds and performance in multiple cognitive domains in 3,979 persons without dementia (mean age, 60.3 years). Mini-Mental State Examination (MMSE) score and neuropsychological tests were used to assess global cognition and the following cognitive domains: memory, information processing speed, executive function, and motor speed. We used number of microbleeds as continuous variable, and additionally distinguished between persons with no microbleeds, 1 microbleed, 2-4 microbleeds, and ≥5 microbleeds. The association of microbleeds with different cognitive domains was estimated using linear regression models. Additional adjustments were made for vascular risk factors, brain atrophy, and other imaging markers of cerebral small vessel disease. We stratified analyses by location of microbleeds.
  
  
  RESULTS
  A higher number of microbleeds was associated with lower MMSE score and worse performance on tests of information processing speed and motor speed. When analyzed per category, presence of 5 or more microbleeds was associated with worse performance in all cognitive domains, except memory. These associations were most robust in participants with strictly lobar microbleeds, whereas after additional adjustments associations disappeared for deep or infratentorial microbleeds.
  
  
  CONCLUSIONS
  Presence of numerous microbleeds, especially in a strictly lobar location, is associated with worse performance on tests measuring cognitive function, even after adjustments for vascular risk factors and other imaging markers of small vessel disease. These results suggest an independent role for microbleed-associated vasculopathy in cognitive impairment.
authors.affiliation: Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
authors.forename: M M F
authors.initials: MM
authors.lastname: Poels
authors.forename: M A
authors.initials: MA
authors.lastname: Ikram
authors.forename: A
authors.initials: A
authors.lastname: van der Lugt
authors.forename: A
authors.initials: A
authors.lastname: Hofman
authors.forename: W J
authors.initials: WJ
authors.lastname: Niessen
authors.forename: G P
authors.initials: GP
authors.lastname: Krestin
authors.forename: M M B
authors.initials: MM
authors.lastname: Breteler
authors.forename: M W
authors.initials: MW
authors.lastname: Vernooij
mesh_terms: D000368:Aged; D001057:Apolipoproteins E / Q000235:genetics; D001284:Atrophy; D001921:Brain / Q000473:pathology; D020520:Brain Infarction / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000150:complications / Q000473:pathology / Q000523:psychology*; D059345:Cerebral Small Vessel Diseases / Q000150:complications / Q000473:pathology / Q000523:psychology*; D003072:Cognition Disorders / Q000209:etiology / Q000473:pathology / Q000523:psychology*; D015331:Cohort Studies; D003627:Data Interpretation, Statistical; D004522:Educational Status; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011930:Reaction Time / Q000502:physiology; D012307:Risk Factors; D014652:Vascular Diseases / Q000453:epidemiology / Q000473:pathology
chemical_list: D001057:Apolipoproteins E