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Updated: May 29, 2026
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Cerebral microbleeds and cognitive functioning in the PROSPER study
A C G M van Es1, J van der Grond, A J M de Craen
1Department of Radiology, Section of Gerontology and Geriatrics, Leiden University Medical Centre, Leiden, the Netherlands. A.C.G.M.van_Es@LUMC.nl
Objectives:
Cerebral microbleeds (MBs) are an important indicator of cerebral small-vessel disease, and their prevalence increases with increasing age. Little is known about the functional consequences of MBs in the aging population. In this study we investigated whether the presence and location of MBs are associated with cognition in the PROSPER study.
Methods:
For 439 subjects the number and location (cortico-subcortical, deep white matter, basal ganglia, and infratentorial) of the MBs was recorded. Difference in cognitive performance between subjects with and without MBs was calculated by entering the variables sex, age, white matter hyperintensity volume, infarction, and MBs in a linear mixed model. Differences in cognition between subjects with and without one or more MBs at different anatomic locations were assessed using the same model.
Results:
We found that after correction for sex, age, white matter hyperintensity volume, and infarction, subjects with infratentorial MBs had a significantly lower score on the Immediate Picture-Word Learning test, Delayed Picture-Word Learning, and Instrumental Activities of Daily Living.
Conclusions:
Our data demonstrate that in elderly individuals at increased vascular risk, infratentorial MBs are associated with loss in cognitive functioning.
Insights
Infratentorial cerebral microbleeds (MBs) are linked to cognitive decline in older adults. This study found that MBs in the infratentorial region correlate with lower scores in learning and daily living activities.
Area of Science:
- Neurology
- Gerontology
- Vascular Medicine
Background:
- Cerebral microbleeds (MBs) are markers of cerebral small-vessel disease, increasing with age.
- The cognitive impact of MBs in the elderly population is not well understood.
- The PROSPER study investigated the association between MBs and cognitive function in aging individuals.
Purpose of the Study:
- To determine if the presence and location of cerebral microbleeds (MBs) are associated with cognitive performance in the PROSPER study cohort.
- To explore the relationship between infratentorial MBs and cognitive decline in elderly individuals.
Main Methods:
- Recorded the number and location of MBs in 439 subjects (cortico-subcortical, deep white matter, basal ganglia, infratentorial).
- Utilized a linear mixed model to compare cognitive performance between subjects with and without MBs, adjusting for sex, age, white matter hyperintensity volume, and infarction.
- Assessed cognitive differences based on the anatomical location of MBs.
Main Results:
- Subjects with infratentorial MBs showed significantly lower scores on the Immediate Picture-Word Learning test.
- Delayed Picture-Word Learning scores were also significantly lower in individuals with infratentorial MBs.
- Performance on Instrumental Activities of Daily Living was negatively associated with the presence of infratentorial MBs.
Conclusions:
- Infratentorial cerebral microbleeds are associated with cognitive impairment in elderly individuals with increased vascular risk.
- The findings highlight the clinical significance of MB location in understanding cognitive decline in aging populations.
