title: Prevalence and Risk Factors of Acute Incidental Infarcts.
abstract: OBJECTIVE
  The study of silent stroke has been limited to imaging of chronic infarcts; acute incidental infarcts (AII) detected on brain magnetic resonance imaging have been less investigated. This study aims to describe prevalence and risk factors of AII in a community and a clinic-based population.
  
  
  METHODS
  Subjects were drawn from 2 ongoing studies: Epidemiology of Dementia in Singapore study, which is a subsample from a population-based study, and a clinic-based case-control study. Subjects from both studies underwent similar clinical and neuropsychological assessments and brain magnetic resonance imaging. Prevalence of AII from these studies was determined. Subsequently, risk factors of AII were examined using multivariable logistic regression models.
  
  
  RESULTS
  AII were seen in 7 of 623 (1.2%) subjects in Epidemiology of Dementia in Singapore (mean age, 70.9±6.8 years; 45% men) and in 12 of 389 (3.2%) subjects (mean age, 72.1±8.3 years; 46% men) in the clinic-based study. AII were present in 0.8% of subjects with no cognitive impairment, 1.9% of those with cognitive impairment not dementia, and 4.2% of subjects with dementia. Significant association of AII was found with cerebral microbleeds (≥5) in the Epidemiology of Dementia in Singapore (odds ratio, 6.76; 95% confidence interval, 1.28-35.65; P=0.02) and in the clinic-based cohort (odds ratio, 4.65; 95% confidence interval, 1.39-15.53; P=0.01). There was no association of AII with hypertension, diabetes mellitus, or hyperlipidemia.
  
  
  CONCLUSIONS
  AII are more likely to be present in those with cognitive impairment. Although a cause-effect relationship between the presence of AII and cognitive impairment is plausible, the association may be because of under-reporting of symptoms by individuals with cognitive impairment. The association between AII and cerebral microbleeds may indicate cerebral vasculopathy, independent of traditional vascular risk factors.
authors: From the Department of Pharmacology, National University of Singapore, Singapore, Singapore (M.S., M.S.P.S., S.H., Y.H.D., C.C.); Department of Medicine, Changi General Hospital, Singapore, Singapore (M.S.); Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore (M.S.P.S., S.H., Y.H.D., N.V., M.K.I., C.C.); Raffles Neuroscience Centre, Department of Neurology, Raffles Hospital, Singapore, Singapore (N.V.); Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore (M.K.I.); and Department of Pharmacology, Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore (M.K.I.).
authors: Monica
authors: M
authors: Saini
authors: From the Department of Pharmacology, National University of Singapore, Singapore, Singapore (M.S., M.S.P.S., S.H., Y.H.D., C.C.); Department of Medicine, Changi General Hospital, Singapore, Singapore (M.S.); Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore (M.S.P.S., S.H., Y.H.D., N.V., M.K.I., C.C.); Raffles Neuroscience Centre, Department of Neurology, Raffles Hospital, Singapore, Singapore (N.V.); Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore (M.K.I.); and Department of Pharmacology, Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore (M.K.I.).
authors: Ma Serrie P
authors: MS
authors: Suministrado
authors: From the Department of Pharmacology, National University of Singapore, Singapore, Singapore (M.S., M.S.P.S., S.H., Y.H.D., C.C.); Department of Medicine, Changi General Hospital, Singapore, Singapore (M.S.); Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore (M.S.P.S., S.H., Y.H.D., N.V., M.K.I., C.C.); Raffles Neuroscience Centre, Department of Neurology, Raffles Hospital, Singapore, Singapore (N.V.); Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore (M.K.I.); and Department of Pharmacology, Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore (M.K.I.).
authors: Saima
authors: S
authors: Hilal
authors: From the Department of Pharmacology, National University of Singapore, Singapore, Singapore (M.S., M.S.P.S., S.H., Y.H.D., C.C.); Department of Medicine, Changi General Hospital, Singapore, Singapore (M.S.); Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore (M.S.P.S., S.H., Y.H.D., N.V., M.K.I., C.C.); Raffles Neuroscience Centre, Department of Neurology, Raffles Hospital, Singapore, Singapore (N.V.); Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore (M.K.I.); and Department of Pharmacology, Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore (M.K.I.).
authors: Yan Hong
authors: YH
authors: Dong
authors: From the Department of Pharmacology, National University of Singapore, Singapore, Singapore (M.S., M.S.P.S., S.H., Y.H.D., C.C.); Department of Medicine, Changi General Hospital, Singapore, Singapore (M.S.); Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore (M.S.P.S., S.H., Y.H.D., N.V., M.K.I., C.C.); Raffles Neuroscience Centre, Department of Neurology, Raffles Hospital, Singapore, Singapore (N.V.); Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore (M.K.I.); and Department of Pharmacology, Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore (M.K.I.).
authors: Narayanaswamy
authors: N
authors: Venketasubramanian
authors: From the Department of Pharmacology, National University of Singapore, Singapore, Singapore (M.S., M.S.P.S., S.H., Y.H.D., C.C.); Department of Medicine, Changi General Hospital, Singapore, Singapore (M.S.); Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore (M.S.P.S., S.H., Y.H.D., N.V., M.K.I., C.C.); Raffles Neuroscience Centre, Department of Neurology, Raffles Hospital, Singapore, Singapore (N.V.); Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore (M.K.I.); and Department of Pharmacology, Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore (M.K.I.).
authors: Mohammad K
authors: MK
authors: Ikram
authors: From the Department of Pharmacology, National University of Singapore, Singapore, Singapore (M.S., M.S.P.S., S.H., Y.H.D., C.C.); Department of Medicine, Changi General Hospital, Singapore, Singapore (M.S.); Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore (M.S.P.S., S.H., Y.H.D., N.V., M.K.I., C.C.); Raffles Neuroscience Centre, Department of Neurology, Raffles Hospital, Singapore, Singapore (N.V.); Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore (M.K.I.); and Department of Pharmacology, Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore (M.K.I.). phccclh@nus.edu.sg.
authors: Christopher
authors: C
authors: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020520:Brain Infarction / Q000150:complications / Q000453:epidemiology*; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000150:complications; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D015995:Prevalence; D012307:Risk Factors
keywords: cognition; infarct; ischemic; neuropsychological test; stroke