Jali Vidishaa, Mishra Nalini K, Vibha Deepti, Dwivedi Sada N, Srivastava Achal K, Verma Vivek, Kumar Amit, Nair Pallavi, Prasad Kameshwar
Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
Department of Neuroimaging and Interventional Neuroradiology, All India Institute of Medical Sciences, New Delhi, India.
Ann Indian Acad Neurol. 2024 May 1;27(3):236-243. doi: 10.4103/aian.aian_71_24. Epub 2024 Jun 21.
Several observational studies have reported the prevalence of cerebral microbleeds (CMBs) and their risk factors in an elderly population. Any information in this regard is currently lacking from India. Aim of this study was to estimate the prevalence, risk factors of CMBs, and association with cognition in an Indian urban population aged 50 years and above.
Household surveys were conducted as part of ongoing Longitudinal Cognition and Aging Research on Population of the National Capital Region (LoCARPoN) study in areas of urban Delhi. Magnetic resonance imaging of the brain was performed in 2599 participants. Using standard neuropsychological battery, mean Z-scores for each domain (memory, executive, information) were derived. Binary and stepwise logistic regression models were used to determine associated risk factors for the presence of CMB and its association with cognitive domains.
The prevalence of CMBs was 14.42% (95% confidence interval [CI]: 13.06-15.73). Of these, 203 (7.81%) participants had single CMBs and 172 (6.61%) had multiple microbleeds (≥2). Higher prevalence was observed in older age (60-70 years: odds ratio [OR]: 1.25 [95% CI: 0.93-1.67]; 70-80 years: OR: 2.05 [95% CI: 1.48-2.84]; ≥80 years: OR: 3.27 [95% CI: 1.97-5.44]) compared to individuals in the age group 50-60 years. History of stroke (OR: 2.97 [95% CI: 1.56-5.66]), hypertension (OR: 1.36 [95% CI: 1.05-1.75]), and smoking (OR: 1.43 [95% CI: 1.11-1.85]) was associated with at least one CMB. Multiple CMBs were associated with worse scores in memory and executive domains.
Older age, hypertension, history of stroke, and history of smoking emerged as important risk factors for the presence of multiple CMBs. Follow-up study is required to determine implications of CMBs.
多项观察性研究报告了老年人群中脑微出血（CMB）的患病率及其危险因素。目前印度缺乏这方面的任何信息。本研究的目的是估计印度50岁及以上城市人群中CMB的患病率、危险因素以及与认知的关联。
作为正在进行的国家首都地区人群纵向认知与衰老研究（LoCARPoN）的一部分，在德里市区进行了家庭调查。对2599名参与者进行了脑部磁共振成像检查。使用标准神经心理测试组合，得出每个领域（记忆、执行功能、信息）的平均Z分数。采用二元和逐步逻辑回归模型来确定CMB存在的相关危险因素及其与认知领域的关联。
CMB的患病率为14.42%（95%置信区间[CI]：13.06 - 15.73）。其中，203名（7.81%）参与者有单个CMB，172名（6.61%）有多个微出血（≥2个）。与50 - 60岁年龄组的个体相比，在60 - 70岁（优势比[OR]：1.25 [95% CI：0.93 - 1.67]）、70 - 80岁（OR：2.05 [95% CI：1.48 - 2.84]）、≥80岁（OR：3.27 [95% CI：1.97 - 5.44]）年龄组中观察到更高的患病率。中风病史（OR：2.97 [95% CI：1.56 - 5.66]）、高血压（OR：1.36 [95% CI：1.05 - 1.75]）和吸烟（OR：1.43 [95% CI：1.11 - 1.85]）与至少一个CMB相关。多个CMB与记忆和执行功能领域的较差分数相关。
年龄较大、高血压、中风病史和吸烟史是多个CMB存在的重要危险因素。需要进行随访研究以确定CMB的影响。
