Prevalence and Risk Factors of Cerebral Microbleeds in Community-Dwelling Adults in Urban Delhi

Abstract

Background: 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. Methods: 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. Results: 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. Conclusion: 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.