Abstract W P164: Cerebral Microbleeds and Physical performance: The Framingham Heart Study
Objective: To study the association of cerebral microbleeds (CMB) on MRI and physical performance in a community based cohort free of stroke and dementia.
Background: Impaired mobility and physical function are associated with increased morbidity and mortality. CMB are believed to be subclinical markers of hemorrhage-prone small vessel disease, but CMB-induced neuronal injury may promote physical impairment in individuals free of stroke and dementia by disrupting the complex cerebral pathways involved in gait control and balance.
Methods: We evaluated 1710 Framingham Offspring Study participants (mean age 64.6 years, 54% women) attending a baseline examination (1998-2008), who had brain MRI allowing for CMB detection and available measurements of physical performance. Walking speed was available in all, while a subset (N≈500) had available standing balance, chair standing and short physical battery scores. Using multivariable logistic regression we related CMB presence overall and stratified by brain location (lobar or deep) to the physical performance measures.
Results: CMB were observed in 7.7% of subjects. We observed an association of presence of any CMB with lower walking speed score (4 vs. <4) after adjustment for age, sex, time between MRI and study exam, and MRI markers of ischemic small vessel disease (OR 0.53, 95% CI 0.30-0.93, p=0.03). The association was no longer significant after adjusting for vascular risk factors (hypertension, diabetes, smoking, prevalent cardiovascular disease) instead of MRI markers (OR 0.63, 95% CI 0.36-1.11, p=0.11). There were no significant associations by CMB location and CMB were not associated with the remaining physical performance measures in the smaller samples.
Conclusions: CMB were associated with lower gait speed, a relation that was partly dependent on presence of vascular risk factors. Our findings are limited by the small sample in subgroups of CMB across physical performance measures other than gait speed, but if replicated in other studies, would suggest a negative impact of CMB on physical function in community dwelling persons without stroke or dementia. These findings are significant given longer life expectancy and increasing prevalence of CMB with age.
Author Disclosures: J.R. Romero: None. S.R. Preis: None. A. Beiser: None. A. Shoamanesh: None. C. DeCarli: None. P.A. Wolf: None. S. Seshadri: None.
- © 2015 by American Heart Association, Inc.