title: Cerebral microbleeds in a multiethnic elderly community: demographic and clinical correlates.
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.
authors.affiliation: Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
authors.forename: Anne F
authors.initials: AF
authors.lastname: Wiegman
authors.affiliation: Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
authors.forename: Irene B
authors.initials: IB
authors.lastname: Meier
authors.affiliation: 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.
authors.forename: Nicole
authors.initials: N
authors.lastname: Schupf
authors.affiliation: 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.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Manly
authors.affiliation: Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
authors.forename: Vanessa A
authors.initials: VA
authors.lastname: Guzman
authors.affiliation: Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
authors.forename: Atul
authors.initials: A
authors.lastname: Narkhede
authors.affiliation: 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.
authors.forename: Yaakov
authors.initials: Y
authors.lastname: Stern
authors.affiliation: Massachusetts General Hospital, Stroke Research Center, Boston, MA, USA.
authors.forename: Sergi
authors.initials: S
authors.lastname: Martinez-Ramirez
authors.affiliation: Massachusetts General Hospital, Stroke Research Center, Boston, MA, USA.
authors.forename: Anand
authors.initials: A
authors.lastname: Viswanathan
authors.affiliation: 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.
authors.forename: José A
authors.initials: JA
authors.lastname: Luchsinger
authors.affiliation: Massachusetts General Hospital, Stroke Research Center, Boston, MA, USA.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Greenberg
authors.affiliation: 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.
authors.forename: Richard
authors.initials: R
authors.lastname: Mayeux
authors.affiliation: 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. Electronic address: amb2139@columbia.edu.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Brickman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000150:complications / Q000453:epidemiology / Q000208:ethnology; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012111:Residence Characteristics; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: Cerebral microbleeds; Multi-ethnic; Small-vessel disease; Stroke; Vascular risk factors; White matter hyperintensities
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