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Microbleeds do not affect rate of cognitive decline in Alzheimer disease

Annelies E van der Vlies1, Jeroen D C Goos, Frederik Barkhof

  • 1Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands. wm.vdflier@vumc.nl

Neurology
|August 10, 2012
PubMed
Abstract

Insights

Brain microbleeds (MBs) do not accelerate cognitive decline in Alzheimer disease (AD). This finding suggests that increased mortality risk in patients with MBs may stem from vascular events rather than faster disease progression.

Area of Science:

  • Neurology
  • Neuroimaging
  • Geriatrics

Background:

  • Alzheimer disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline.
  • Brain microbleeds (MBs) are small, punctate hemorrhages often detected on MRI, associated with cerebrovascular disease.
  • The impact of MBs on the rate of cognitive decline in AD patients remains an area of active investigation.

Purpose of the Study:

  • To determine the relationship between the presence and burden of brain microbleeds (MBs) and the rate of cognitive decline in individuals diagnosed with Alzheimer disease (AD).

Main Methods:

  • A cohort study involving 221 patients with AD was conducted.
  • Baseline MRI scans and serial Mini-Mental State Examination (MMSE) scores over a mean follow-up of 3 years were analyzed.
  • Linear mixed models were employed to assess the influence of MBs on cognitive decline, controlling for covariates.

Main Results:

  • No significant association was found between the presence of MBs and the baseline MMSE score or the rate of cognitive decline in AD patients.
  • Adjustments for factors like atrophy, white matter hyperintensities, lacunes, vascular risk factors, MB location, and APOE ε4 status did not alter these findings.
  • Analysis using the number of MBs as a predictor yielded similar results, indicating no impact on cognitive decline rate.

Conclusions:

  • Brain microbleeds (MBs) do not appear to influence the rate of cognitive decline in patients with Alzheimer disease (AD).
  • The previously observed higher mortality risk in AD patients with MBs may be attributed to vascular events, such as stroke, rather than a more rapid disease progression.
  • Further research into the specific mechanisms linking MBs to mortality in AD is warranted.

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