CEREBRAL MICROBLEEDS AND VASCULAR RISK FACTORS IN ALZHEIMER’S DISEASE

Background Cerebral microbleeds (CMBs) are common in Alzheimer’s disease (AD) and may reflect underlying vascular and neurodegenerative changes. This study aimed to investigate differences in cardiovascular risk factors, clinical history, typical AD biomarkers, and MRI features between AD patients with and without CMBs. Materials and Methods We conducted a retrospective cross-sectional study including 138 AD patients attending the Memory Clinic at Ospedale Civile di Baggiovara. Clinical histories, laboratory values closest to the MRI date, and MRI scans/reports were reviewed. Variables analyzed included cardiovascular risk factors (hypertension, dyslipidemia, diabetes mellitus, etc.), clinical comorbidities (history of epilepsy, psychiatric history, etc.), AD biomarkers, and MRI features (white matter hyperintensities, cortical superficial siderosis, Fazekas scale, intracerebral hemorrhage, probable/possible cerebral amyloid angiopathy, etc.). Group comparisons, as well as univariate and multivariate regression analyses were performed to identify associations with CMBs. Results Compared to patients without CMBs, those with CMBs showed significant differences in clinical variables (age, gender, history of epilepsy, diabetes mellitus) and MRI features (white matter hyperintensities, cortical superficial siderosis, intracerebral hemorrhage, Fazekas scale, probable or possible cerebral amyloid angiopathy) (all p<0.05). Univariate regression analysis identified age (p=0.004), diabetes mellitus (p=0.02), history of epilepsy (p=0.038), cortical superficial siderosis (p=0.031), Fazekas scale (overall (p<0.001) and scores 2 (p<0.001) and 3 (p=0.011) versus score 0), and white matter hyperintensities (p=0.005) as significantly associated with CMBs. In multivariate regression, diabetes mellitus (p=0.047), Fazekas scale (overall (p=0.046) and score 2 (p=0.008) versus score 0), and white matter hyperintensities (p=0.016) remained independent predictors. Discussion These findings suggest that vascular and MRI-related variables, particularly diabetes mellitus, white matter changes, and Fazekas score, are associated with the presence of CMBs in AD patients. Our results are consistent with previous studies in the literature, supporting their potential role in guiding clinical management and risk stratification in this population.