Cerebral microbleeds are a finding on MRI that are usually asymptomatic. There are two main aetiological pathways, one occurring as a result of uncontrolled hypertension and the other from the accumulation of amyloid-beta peptide. The link between cerebral amyloid angiopathy and Alzheimer’s Disease is not understood and even the impact that cerebral microbleeds more generally have on cognition. 

For the study discussed today, clients of an Australian memory clinic were retrospectively assessed for prevalence of cerebral microbleeds and how this correlates to performance on cognitive tests and formal diagnosis categories. Prevalence of multiple cerebral microbleeds was associated with poorer cognitive performance and more severe diagnoses. And there are suggestions of a shared instigator between Alzheimer’s Disease cerebral amyloid angiopathy. But novel anti-amyloid therapies can also cause increased bleeding risk, meaning that multiple microbleeds are a contraindication for these drugs. We hear how clinicians in the memory clinic balance therapeutic outcomes and potential risks.  

Guest
Associate Professor Paul Yates FRACP PhD (Austin Health; University of Melbourne)
 
Co-Host
Dr Duncan Austin FRACP PhD (Alfred Health; Cabrini Health)

Production
Produced by Dr Duncan Austin and Mic Cavazzini. Music licenced from Epidemic Sound includes 

‘Tree Tops’ by Autohacker and ‘Fugent’ by Lupus Nocte. Image created and copyrighted by RACP. 

Editorial feedback kindly provided by RACP physicians Stephen Bacchi, Joseph Lee and Aidan Tan.

Key Reference
Prevalence and Associations of Cerebral Microbleeds in an Australian Memory Clinic Cohort [IMJ. 2025]

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