Chronic obstructive pulmonary disease and cerebral microbleeds: the Rotterdam study

Rationale: Chronic obstructive pulmonary disease (COPD) is a common, complex multisystem disease in the elderly with multiple comorbidities that significantly impact morbidity and mortality. Although cerebral small-vessel disease is an important cause of cognitive decline and age-related disability, it is a poorly investigated potential systemic manifestation of patients with COPD. Objectives: To examine whether COPD relates to the development and location of cerebral microbleeds, a novel marker of cerebral small-vessel disease. Methods: Cross-sectional and longitudinal analyses were part of the Rotterdam Study, a prospective population-based cohort study in subjects aged ≥55 years. Diagnosis of COPD was confirmed by spirometry. Cerebral microbleeds were detected using high-resolution Magnetic Resonance Imaging (MRI). Main Results: Subjects with COPD (n = 165) had a higher prevalence of cerebral microbleeds compared to subjects with normal lung function (n = 645) independent of age, sex, smoking status, atherosclerotic macroangiopathy, antithrombotic use, total cholesterol, triglycerides, and serum creatinin (OR 1.7, 95%CI 1.15-2.47, p=0.007). Regarding the specific microbleed location, COPD subjects had a significantly higher prevalence of microbleeds in deep or infratentorial locations (OR 3.3, 95%CI 1.97-5.53, p