Cerebral Microinfarcts and Dementia: A Systematic Review and Metaanalysis

Objective: To systematically review the relationship between the cerebral microinfarcts and dementia. Methods: We conducted a systematic review and meta-analyses using the MEDLINE, EMBASE, the Cochrane library, and BIOSIS preview for studies published in the period from January 1(st), 1997 to April 1(st), 2014. We also searched the reference lists of relevant studies and review articles. Studies had to be controlled, with participants divided into a dementia group and a control group. Experimental participants included must be demented individuals with dementia syndromes (dementia overall, AD, and vascular dementia (VaD)). Outcome measures should include the presence of microinfarcts lesions. The effect size was estimated as odds ratio (OR) with 95% confidence intervals (CIs). Heterogeneity was assessed using Cochran's Q-test and I-2-statistic. Results: We pooled data from 12 studies, including 2181 people. Cerebral microinfarcts were significantly associated with dementia in random effects model [ the odds ratios (OR) 2.15, 95% confidence interval (95% CI) 1.46-3.15, P=0.0008]. There was no evidence of an association between the microinfarcts and Alzheimer's disease (AD) in random effects model (OR 2.81, 95% CI 0.94-8.42, P=0.06). Conclusion: These results suggest that cerebral microinfarcts are significantly associated with dementia. Whether cerebral microinfarcts are associated with AD needs to be further investigated.