Introduction: Cerebral small vessel disease (CSVD) is a significant burden of morbidity and mortality among elderly people around the world. Epidemiological data with complete CSVD evaluations and a large sample size in the general population are still limited. Methods: Community-dwelling residents in Lishui city in China from the cross-sectional survey of the Polyvascular Evaluation for Cognitive Impairment and Vascular Events (PRECISE) study were included in this study from 2017 to 2019. All participants underwent 3 Tesla brain magnetic resonance images to assess CSVD imaging markers. Demographic and risk factor data were collected. The general and age-specific prevalence of lacune, confluent white matter hyperintensity (WMH), moderate-severe enlarged perivascular spaces (EPVS), cerebral microbleed (CMB), and total CSVD score (an ordinal scale from 0 to 4, counting the presence of four imaging markers of CSVD) was evaluated. Associations between vascular risk factors and these markers were analyzed by multivariable logistic regression. Results: A total of 3,063 participants were enrolled. The mean age was 61.2 years and 46.5% were men. The most prevalent CSVD marker was confluent WMH (16.7%), followed by CMB (10.2%), moderate-severe EPVS in the basal ganglia (BG-EPVS) (9.8%), and lacune (5.6%). 30.5% of the participants have at least one of the four markers (total CSVD score ≥1 points). The prevalence of CSVD markers increases as age increases. Age and hypertension were independent risk factors for four CSVD markers and the total CSVD score. Conclusions: In this Chinese cohort with community-based adults aged 50–75 years, our findings showed a prevalence of 30.5% for CSVD. The most prevalent CSVD marker was confluent WMH, followed by CMB, moderate-severe BG-EPVS, and lacune. The risk factors for CSVD must be strictly screened and controlled in adults living in the community.

1.
Wardlaw JM, Smith C, Dichgans M. Small vessel disease: mechanisms and clinical implications. Lancet Neurol. 2019;18(7):684–96.
2.
Pantoni L. Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges. Lancet Neurol. 2010;9(7):689–701.
3.
Wardlaw JM, Smith EE, Biessels GJ, Cordonnier C, Fazekas F, Frayne R, et al. Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration. Lancet Neurol. 2013;12(8):822–38.
4.
Staals J, Makin SD, Doubal FN, Dennis MS, Wardlaw JM. Stroke subtype, vascular risk factors, and total MRI brain small-vessel disease burden. Neurology. 2014;83(14):1228–34.
5.
Joutel A. Prospects for diminishing the impact of nonamyloid small-vessel diseases of the brain. Annu Rev Pharmacol Toxicol. 2020;60:437–56.
6.
Das AS, Regenhardt RW, Vernooij MW, Blacker D, Charidimou A, Viswanathan A. Asymptomatic cerebral small vessel disease: insights from population-based studies. J Stroke. 2019;21(2):121–38.
7.
Han F, Zhai FF, Wang Q, Zhou LX, Ni J, Yao M, et al. Prevalence and risk factors of cerebral small vessel disease in a Chinese population-based sample. J Stroke. 2018;20(2):239–46.
8.
Jiang Y, Cui M, Tian W, Zhu S, Chen J, Suo C, et al. Lifestyle, multi-omics features, and preclinical dementia among Chinese: the Taizhou Imaging Study. Alzheimers Dement. 2021;17(1):18–28.
9.
Pan Y, Jing J, Cai X, Wang Y, Wang S, Meng X, et al. PolyvasculaR Evaluation for Cognitive Impairment and vaScular Events (PRECISE)-a population-based prospective cohort study: rationale, design and baseline participant characteristics. Stroke Vasc Neurol. 2021;6(1):145–51.
10.
Liu D, Cai X, Yang Y, Wang S, Yao D, Mei L, et al. Associations of life’s simple 7 with cerebral small vessel disease. Stroke. 2022;53(9):2859–67.
11.
Yao D, Li S, Jing J, Cai X, Jin A, Yang Y, et al. Association of serum cystatin C with cerebral small vessel disease in community-based population. Stroke. 2022;53(10):3123–32.
12.
Fazekas F, Chawluk JB, Alavi A, Hurtig HI, Zimmerman RA. MR signal abnormalities at 1.5 T in Alzheimer’s dementia and normal aging. AJR Am J Roentgenol. 1987;149(2):351–6.
13.
Klarenbeek P, van Oostenbrugge RJ, Rouhl RP, Knottnerus IL, Staals J. Ambulatory blood pressure in patients with lacunar stroke: association with total MRI burden of cerebral small vessel disease. Stroke. 2013;44(11):2995–9.
14.
Longstreth WTJr, Manolio TA, Arnold A, Burke GL, Bryan N, Jungreis CA, et al. Clinical correlates of white matter findings on cranial magnetic resonance imaging of 3,301 elderly people. The Cardiovascular Health Study. Stroke. 1996;27(8):1274–82.
15.
Price TR, Manolio TA, Kronmal RA, Kittner SJ, Yue NC, Robbins J, et al. Silent brain infarction on magnetic resonance imaging and neurological abnormalities in community-dwelling older adults. The Cardiovascular Health Study. CHS Collaborative Research Group. Stroke. 1997;28(6):1158–64.
16.
Liao D, Cooper L, Cai J, Toole JF, Bryan NR, Hutchinson RG, et al. Presence and severity of cerebral white matter lesions and hypertension, its treatment, and its control. The ARIC Study. Atherosclerosis Risk in Communities Study. Stroke. 1996;27(12):2262–70.
17.
Schmidt R, Fazekas F, Kapeller P, Schmidt H, Hartung HP. MRI white matter hyperintensities: three-year follow-up of the Austrian Stroke Prevention Study. Neurology. 1999;53(1):132–9.
18.
Roob G, Schmidt R, Kapeller P, Lechner A, Hartung HP, Fazekas F. MRI evidence of past cerebral microbleeds in a healthy elderly population. Neurology. 1999;52(5):991–4.
19.
Schmidt R, Schmidt H, Pichler M, Enzinger C, Petrovic K, Niederkorn K, et al. C-reactive protein, carotid atherosclerosis, and cerebral small-vessel disease: results of the Austrian Stroke Prevention Study. Stroke. 2006;37(12):2910–6.
20.
Poels MM, Vernooij MW, Ikram MA, Hofman A, Krestin GP, van der Lugt A, et al. Prevalence and risk factors of cerebral microbleeds: an update of the Rotterdam scan study. Stroke. 2010;41(10 Suppl):S103–6.
21.
Vermeer SE, Koudstaal PJ, Oudkerk M, Hofman A, Breteler MM. Prevalence and risk factors of silent brain infarcts in the population-based Rotterdam Scan Study. Stroke. 2002;33(1):21–5.
22.
de Leeuw FE, de Groot JC, Achten E, Oudkerk M, Ramos LM, Heijboer R, et al. Prevalence of cerebral white matter lesions in elderly people: a population based magnetic resonance imaging study. The Rotterdam Scan Study. J Neurol Neurosurg Psychiatry. 2001;70(1):9–14.
23.
DeCarli C, Massaro J, Harvey D, Hald J, Tullberg M, Au R, et al. Measures of brain morphology and infarction in the framingham heart study: establishing what is normal. Neurobiol Aging. 2005;26(4):491–510.
24.
Romero JR, Preis SR, Beiser A, DeCarli C, Viswanathan A, Martinez-Ramirez S, et al. Risk factors, stroke prevention treatments, and prevalence of cerebral microbleeds in the Framingham Heart Study. Stroke. 2014;45(5):1492–4.
25.
Tully PJ, Alperovitch A, Soumare A, Mazoyer B, Debette S, Tzourio C. Association between cerebral small vessel disease with antidepressant use and depression: 3C dijon magnetic resonance imaging study. Stroke. 2020;51(2):402–8.
26.
Hilal S, Mok V, Youn YC, Wong A, Ikram MK, Chen CL. Prevalence, risk factors and consequences of cerebral small vessel diseases: data from three Asian countries. J Neurol Neurosurg Psychiatry. 2017;88(8):669–74.
27.
Zhou LW, Panenka WJ, Al-Momen G, Gicas KM, Thornton AE, Jones AA, et al. Cerebral small vessel disease, risk factors, and cognition in tenants of precarious housing. Stroke. 2020;51(11):3271–8.
28.
Inzitari D, Simoni M, Pracucci G, Poggesi A, Basile AM, Chabriat H, et al. Risk of rapid global functional decline in elderly patients with severe cerebral age-related white matter changes: the LADIS study. Arch Intern Med. 2007;167(1):81–8.
29.
Benjamin P, Viessmann O, MacKinnon AD, Jezzard P, Markus HS. 7 Tesla MRI in cerebral small vessel disease. Int J Stroke. 2015;10(5):659–64.
30.
Yin ZG, Wang QS, Yu K, Wang WW, Lin H, Yang ZH. Sex differences in associations between blood lipids and cerebral small vessel disease. Nutr Metab Cardiovasc Dis. 2018;28(1):28–34.
You do not currently have access to this content.