Department of Radiology and Nuclear Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Alzheimers Dement. 2018 Nov;14(11):1482-1492. doi: 10.1016/j.jalz.2018.04.007. Epub 2018 May 21.
Cerebral small vessel disease is increasingly linked to dementia.
We systematically searched Medline, Embase, and Cochrane databases for prospective population-based studies addressing associations of white matter hyperintensities, covert brain infarcts (i.e., clinically silent infarcts), and cerebral microbleeds with risk of all-dementia or Alzheimer's disease and performed meta-analyses.
We identified 11 studies on white matter hyperintensities, covert brain infarcts, or cerebral microbleeds with risk of all-dementia or Alzheimer's disease. Pooled analyses showed an association of white matter hyperintensity volume and a borderline association of covert brain infarcts with risk of all-dementia (hazard ratio: 1.39 [95% confidence interval: 1.00; 1.94], N = 3913, and 1.47 [95% confidence interval: 0.97; 2.22], N = 8296). Microbleeds were not statistically significantly associated with an increased risk of all-dementia (hazard ratio: 1.25 [95% confidence interval: 0.66; 2.38], N = 8739).
White matter hyperintensities are associated with an increased risk of all-dementia and Alzheimer's disease in the general population. However, studies are warranted to further determine the role of markers of cerebral small vessel disease in dementia.
脑小血管病与痴呆的关系日益密切。
我们系统地检索了 Medline、Embase 和 Cochrane 数据库，以寻找针对白质高信号、隐匿性脑梗死（即临床无症状梗死）和脑微出血与全痴呆或阿尔茨海默病风险之间关联的前瞻性人群研究，并进行了荟萃分析。
我们确定了 11 项关于白质高信号、隐匿性脑梗死或脑微出血与全痴呆或阿尔茨海默病风险的研究。汇总分析显示，白质高信号体积与全痴呆风险相关，隐匿性脑梗死与全痴呆风险呈边缘相关（风险比：1.39 [95%置信区间：1.00；1.94]，N=3913；1.47 [95%置信区间：0.97；2.22]，N=8296）。微出血与全痴呆风险无统计学显著相关性（风险比：1.25 [95%置信区间：0.66；2.38]，N=8739）。
在普通人群中，白质高信号与全痴呆和阿尔茨海默病的风险增加相关。然而，需要进一步的研究来确定脑小血管病标志物在痴呆中的作用。
