Similarly in the ACT specimens, microinfarcts were strongly associated with macro-infarcts (OR 2.9, 95% CI 1.4, 6.3). In NACC specimens, after controlling for age and sex in multivariable models, microinfarcts were strongly associated with macro-infarcts (odds ratio (OR) 4.4, 95% confidence interval (CI) 3.8, 5.0), leukoencephalopathy (OR 2.6, 95% CI 2.1, 3.3), and hemorrhages (OR 2.0, 95% CI 1.6, 2.6). Despite different definitions being used, micro-infarcts were common in both studies (19.7% in NACC and 16.0% in ACT), and their frequency increased significantly with age. Considering only subjects 65 years of older at death, micro-infarcts were evaluated in 6,189 from NACC and 219 from ACT. We sought associations between such findings and microinfarcts in neuropathology databases from the National Alzheimer's Coordinating Center (NACC) and the Adult Changes in Thought (ACT) study. We sought to identify what neuropathologic vascular findings - likely to be evident on brain MRI during life - would predict the presence of micro-infarcts. Clinicians may undervalue brain micro-infarcts because they are defined by neuropathology and not seen on MRI.
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