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Origins of Microbleeds
Past studies have established that microbleeds are not a predictive sign of Alzheimer's disease, and their root cause is still unknown. But researchers know they are evidence of very small ruptures in the brain's blood vessels, Van der Flier said.
There are two ways microbleeds could occur. The first is that some risk factors — such as smoking, diabetes or hypertension — deprive the brain's blood vessels of oxygen, causing them to stiffen and increasing their likelihood of tearing, he said.
Microbleeds could also crop up from deposits of amyloid beta proteins — long thought to be at work in Alzheimer's — gathering in vessel walls. The protein buildup damages the vessels, spurring microbleeds, he said.
Researchers have long known that blood vessel damage is common among Alzheimer's patients. And past studies have shown that people with high blood pressure, blood vessel disorders and those who've suffered strokes are at an increased risk of Alzheimer's disease, said Maria C. Carrillo, senior director of Medical and Scientific Relations at the Alzheimer's Association, who was not involved with the study.
There is not yet enough evidence to say that microbleeds are associated with Alzheimer's disease, but they are a sign of vascular damage that could contribute to the disease, she said.
Gateway to personalized medicine
The review shows that the cause of Alzheimer's isn't necessarily the same for everyone, Carrillo said.
"It's a perfect storm building up over time, and the contributors to that storm are different because everyone is different — including genetics, lifestyle — all those things combined," Carrillo told MyHealthNewsDaily. "They make your risk factors different from mine."
And if Alzheimer's has multiple causes, the disease might be managed more effectively taking that into consideration, rather than treating it in a one-size-fits-all way, she said.
"[A microbleed] could be a contributor in some people, and in others it's not," Carrillo said. "So we can't look at it as the only cause, but it's important to see what its role is in people who actually have one."