Microvascular disease and motoric dysfunction

Abstract

Buchman et al.1 report that the presence of microvascular disease (microinfarcts, cerebral amyloid angiopathy, and arteriolosclerosis) in brain autopsies done in 850 community-dwelling older adults was associated with motor impairments measured prior to death. These and other microvascular lesions such as cortical microbleeds are common in aging brains, but their clinical significance is not well-established.1,2 Some recent studies have linked microvascular lesions to risk of cognitive decline, but the relationship of this class of vascular lesions with various other geriatric syndromes is understudied. As with any retrospective study there are other role players (confounders, in epidemiology speak) that might explain the observed associations.1 However, even after accounting for several major confounders, including vascular risk factors and disease, interval between the last examination and death, and presence of terminal cognitive impairment or dementia, the relationship with motor dysfunction survived.1