Abstract
OBJECTIVE: This study aims to assess the correlation between cerebral small vessel disease (CSVD) imaging markers and the risk of Alzheimer's disease (AD) through a systematic review and meta-analysis. METHODS: In July 2024, two researchers independently conducted a thorough literature search across databases such as PubMed, Embase, Web of Science, and the Cochrane Library. The selected studies investigated the correlations between white matter hyperintensities (WMHs), cerebral microbleeds (CMBs), lacunar infarction (LI), and enlarged perivascular spaces (EPVS) and the risk of AD. The Newcastle-Ottawa Scale (NOS) was employed to assess the risk of bias in the included cohort and case-control studies. RESULTS: A total of 6,487 articles were identified, with 15 articles meeting the inclusion criteria. Pooled analyses showed that WMHs (HR: 1.38, 95% CI: 1.10-1.74, N = 7,661), CMBs (HR: 1.60, 95% CI: 1.07-2.40, N = 6,567), and EPVS (HR: 1.84, 95% CI: 1.24-2.72, N = 3,045) were associated with an increased risk of AD, with EPVS showing the strongest correlation. LI did not show a statistically significant association with an increased risk of AD (HR: 1.41, 95% CI: 0.98-2.01, N = 4,014). CONCLUSION: WMHs, CMBs, and EPVS are associated with an elevated risk of AD, whereas LI is considered a potential risk factor. However, additional studies are required to determine the role of CSVD markers in AD progression.