Enlarged perivascular spaces and mild behavioral impairment: A cross-sectional analysis in dementia-free older adults - Poster Presentation - Results and conclusion summary

Sep 30, 2026

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Background: Enlarged perivascular spaces (EPVS) and mild behavioral impairment (MBI) relate to higher dementia risk. This cross-sectional study tested associations between EPVS burden and MBI presence and symptom severity in dementia-free older adults from the COMPASS-ND cohort. Methods: EPVS were rated on validated T2-weighted MRI; MBI was measured with the informant MBI Checklist (cut-point ≥6). Multivariable logistic and zero-inflated negative binomial models adjusted for age, education, and MoCA, including EPVS×sex.

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DOI: 10. 1002/alz70856_105336 BIOMARKERS POSTER PRESENTATION NEUROIMAGING Enlarged perivascular spaces and mild behavioral impairment: A cross-sectional analysis in dementia-free older adults Dinithi Mudalige1, 2 Aravind Ganesh2, 3 Dylan X. Guan3, 4 Zahinoor Ismail2, 3 | Graham A. McLeod2 | Eric E. Smith3, 5 | | --- | --- | 1 University of British Columbia, Kelowna, BC, Canada 2 University of Calgary, Calgary, AB, Canada 3 Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada 4 University of Toronto, Toronto, ON, Canada 5 Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada Correspondence Dinithi Mudalige, University of British Columbia, Kelowna, BC, Canada. [Email:](Email: dinithim@student.ubc.ca)[ dinithim@student.ubc.ca](Email: dinithim@student.ubc.ca) Abstract Background: Enlarged perivascular spaces (EPVS) and mild behavioral impairment (MBI) are associated with greater dementia risk. We investigated cross-sectional associations between EPVS burden and MBI presence and symptom severity. Methods: Participants were dementia-free older adults in the Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) study. EPVS were assessed using a validated visual rating scale applied to T2-weighted magnetic resonance imaging. MBI was measured using the informant-reported MBI Checklist (MBI-C) with a cut-point of ≥6 for MBI presence. Multivariable logistic and zeroinflated negative binomial regressions modelled EPVS associations with MBI presence and symptom severity, respectively, adjusting for age, education, and Montreal Cognitive Assessment score, with and EPVS*sex interaction term. Results: Among 363 participants (52. 9% female), every 1-point rise in total EPVS score was associated with 1.29-fold greater odds of having MBI (95%CI:1.07–1.54, p = 0.007). When examining regional EPVS burden, those with higher centrum semiovale scores had greater odds of MBI (aOR= 1.48, 95%CI:1.09–12.02, p = 0.01), but this association was not significant for the basal ganglia (aOR= 1. 39, 95%CI:0.97– 1. 99, p = 0.07) or midbrain (aOR= 1.48, 95%CI:0.80–2. 76, p = 0. 21). Total and regional EPVS scores were not associated with MBI symptom severity. None of the associations were moderated by sex. Conclusion: Older adults with greater global and centrum semiovale EPVS burden are more likely to have MBI. These findings suggest that early microvascular pathology may contribute to later-life emergent and persistent behavioural symptoms, although longitudinal data are required, along with other indicators of vascular pathology. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2025 The Alzheimer’s Association. Alzheimer’s & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer’s Association. Alzheimer’s Dement. 2025;21(Suppl. 2):e105336. [https://doi.org/10.1002/alz70856_105336](https://doi.org/10.1002/alz70856_105336) wi[leyonlinelibrary.com/journal/alz](leyonlinelibrary.com/journal/alz) 1of1

FAQs

What was the study’s main aim?

To examine cross-sectional associations between EPVS burden and both MBI presence and MBI symptom severity in dementia-free older adults.

How were EPVS and MBI measured?

EPVS were assessed using a validated visual rating scale on T2-weighted MRI. MBI was measured using the informant-reported MBI Checklist with a cut-point of ≥6 for MBI presence.

What did the results show about EPVS and MBI?

Each 1-point increase in total EPVS score was associated with higher odds of having MBI. Higher centrum semiovale EPVS burden showed increased odds as well, while associations with basal ganglia or midbrain EPVS were not significant.

Were any associations affected by sex?

No. The study reports that none of the associations were moderated by sex.

Sep 30, 2026

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