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Microinfarct pathology, dementia, and cognitive systems
Arvanitakis Z, Leurgans SE, Barnes LL, Bennett DA, Schneider JA.. Stroke, 2011-01-06
Topic: Brain imaging, connectivity and assessment
Background and purpose Little is known about the role of microinfarcts in dementia and cognition. We examined microinfarcts and dementia, global cognition, and 5 cognitive systems in community-dwelling older persons. Methods Four hundred twenty-five subjects enrolled in the Religious Orders Study underwent annual clinical evaluations, including 19 neuropsychological tests and assessment for dementia, and brain autopsy (39% men; mean age at death, 87; Mini-Mental State Examination score, 21). Neuropathologic examination documented the presence, number, and location of chronic microinfarcts on 6-μm hematoxylin-eosin-stained sections from cortical and subcortical regions. Multiple regression analyses adjusted for age at death, sex, education, macroscopic infarcts, Alzheimer disease pathology, and Lewy bodies. Results Microinfarcts were present in 129 of 425 (30%) persons (54 cortical, 80 subcortical, 49 multiple); 58 of 129 (45%) of persons with microinfarcts did not exhibit macroscopic infarcts. Persons with microinfarcts had increased odds of dementia (OR, 1.77; 95% CI, 1.07-2.92), especially those persons with multiple cortical microinfarcts. Microinfarcts were also associated with lower average global cognition (estimate, -0.287; SE, 0.113; P=0.012), particularly for persons with multiple cortical microinfarcts. Microinfarcts were specifically associated with lower episodic memory (estimate, -0.279; SE, 0.138; P=0.044), semantic memory (estimate, -0.391; SE, 0.130; P=0.003), and perceptual speed (estimate, -0.400; SE, 0.117; P<0.001). In addition, single, multiple, and cortical microinfarcts were associated with worse semantic memory and perceptual speed (all P<0.028). Neither macroscopic infarcts nor AD pathology modified these associations (all P>0.154). Conclusions Microinfarcts are common, and persons with multiple cortical microinfarcts have higher odds of dementia. Microinfarcts are also associated with lower cognition, specifically perceptual speed and semantic and episodic memory.
Key findings
- Results Microinfarcts were present in 129 of 425 (30%) persons (54 cortical, 80 subcortical, 49 multiple); 58 of 129 (45%) of persons with microinfarcts did not exhibit macroscopic infarcts.
- Microinfarcts were also associated with lower average global cognition (estimate, -0.287; SE, 0.113; P=0.012), particularly for persons with multiple cortical microinfarcts.
- Microinfarcts were specifically associated with lower episodic memory (estimate, -0.279; SE, 0.138; P=0.044), semantic memory (estimate, -0.391; SE, 0.130; P=0.003), and perceptual speed (estimate, -0.400; SE, 0.117; P<0.001).
- In addition, single, multiple, and cortical microinfarcts were associated with worse semantic memory and perceptual speed (all P<0.028).
- Conclusions Microinfarcts are common, and persons with multiple cortical microinfarcts have higher odds of dementia.
Study details
- Evidence strengthLow
How this study scored 36/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 21 of the 58 points we could judge it on, which is 36 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Stroke) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2011 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 21212395) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 21 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 21 of the 58 points we could judge it on is 36 out of 100. |
| Total | 36 / 100 | — |
What each of these 20 components measures, and what this score is not →
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APA 7th
Arvanitakis, Z., Leurgans, S. E., Barnes, L. L., Bennett, D. A., & Schneider, J. A. (2011). Microinfarct pathology, dementia, and cognitive systems. Stroke. https://doi.org/10.1161/strokeaha.110.595082
Vancouver
Arvanitakis Z, Leurgans SE, Barnes LL, Bennett DA, Schneider JA. Microinfarct pathology, dementia, and cognitive systems. Stroke. 2011. doi:10.1161/strokeaha.110.595082. PMID: 21212395.
BibTeX
@article{arvanitakis2011-21212395,
author = {Arvanitakis, Z. and Leurgans, S. E. and Barnes, L. L. and Bennett, D. A. and Schneider, J. A.},
title = {{Microinfarct pathology, dementia, and cognitive systems}},
journal = {Stroke},
year = {2011},
doi = {10.1161/strokeaha.110.595082},
pmid = {21212395},
url = {https://doi.org/10.1161/strokeaha.110.595082}
}
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