O5‐02‐01: PREVALENCE, TOPOGRAPHY, AND RISK FACTORS OF CEREBRAL MICROBLEEDS IN DEMENTIA

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Cerebral microbleeds (CMBs) are histologically seen as minute hemosiderin deposits in the brain parenchyma, and on MRI, SWI and T2* sequences, as round hypointense foci. CMBs develop due to two diseases common in a memory clinic: hypertension, causing CMBs in deep and infratentorial regions of the brain, and cerebral amyloid angiopathy, causing CMBs in lobar brain regions. Thus, by investigating the prevalence, topography, and risk factors of CMBs in dementia we aimed to obtain an insight in the disease mechanisms of different dementia diagnoses. In this prospective study we analysed consecutive patients with Alzheimer's disease (n=435), vascular dementia (n=63), and mild (n=439) and subjective (n=403) cognitive impairment, undergoing dementia investigation at the memory clinic Karolinska University Hospital, Huddinge, 2006-2012. A total of 1340 patients (mean age 63 (±10), 53% female) were recruited. All patients had an MRI of the brain, with SWI and/or T2* sequences, and the number and topography of CMBs were assessed. Clinical data was obtained from the dementia investigation. Among the 1340 patients 22% had CMBs. Patients with CMBs had significantly higher age (P<0.001), were more frequently male (P<0.001), had lower cognitive score (P=0.001), and had more often hyperlipidemia (P=0.03) and hypertension (P<0.001). Subgroup analysis showed that hyperlipidemia and hypertension had significantly higher prevalence of CMBs only in mild and subjective cognitive impairment. Odds ratios for developing CMBs increased with the amount of risk factors (hypertension, hyperlipidemia, diabetes, male gender, and age 65 and over) in the whole group. Prevalence, topography, and risk factors of CMBs vary depending on dementia diagnosis and reflect the inherent pathology of different dementia diagnoses. Future studies should focus on further imaging and cerebrospinal fluid markers in relation to CMBs. Prevalence of CMBs depending on number of risk factors. Risk factors are: hypertension, hyperlipidemia, diabetes, male gender and high age defined as 65 years and above. Odds Ratios of developing CMBs for number of risk factors. Risk factors are: hypertension, hyperlipidemia, diabetes, male gender and high age defined as 65 years and above. Patients with 0 risk factors are used as a reference. * P<0.05; ** P<0.001.

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