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They are also observed in treatment\u2010na\u00efve older adults. This study explored relationships with modifiable and non\u2010modifiable risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>This cross\u2010sectional study included 1414 cognitively unimpaired, treatment\u2010na\u00efve individuals aged 60 to 85 years from the Cognitive Health in Ageing Register: Investigational, Observational and Trial Studies in Dementia Research (CHARIOT): Prospective Readiness cOhort (PRO) SubStudy. Relationships between CMHs\/SS and cardiovascular risk factors, amyloid beta (A\u03b2) load, apolipoprotein E (<jats:italic>APOE<\/jats:italic>) \u03b54 status, educational attainment, and white matter hyperintensities were investigated using regression analyses and structural equation modeling.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>CMHs were observed in 8.3% of participants and SS in 1.3%. Significant risk factors for CMHs included age and hypertension. Higher education attainment appeared to have a protective effect. Elevated amyloid is a risk factor, particularly when adjusting for <jats:italic>APOE<\/jats:italic> \u03b54 status in individuals aged 70 or younger.<\/jats:p><\/jats:sec><jats:sec><jats:title>DISCUSSION<\/jats:title><jats:p>Increasing age and hypertension are significant risk factors of CMHs. Higher educational attainment may offer a protective effect.<\/jats:p><\/jats:sec><jats:sec><jats:title>Highlights<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Of the 1414 participants from the CHARIOT\u2010PRO SubStudy (CPSS), CMHs were present in 118 (8.3%), and SS was present in 18 (1.3%).<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Age and hypertension were identified as significant risk factors for CMHs, and the latter had a stronger association with the presence of CMHs among female participants. Having a bachelor's degree or higher was found to be protective.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Elevated brain amyloid burden, particularly when adjusted for <jats:italic>APOE<\/jats:italic> \u03b54 carrier status, was identified as a risk factor in individuals aged 70 years and below.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec>","DOI":"10.1002\/alz.70594","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T08:53:23Z","timestamp":1755680003000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence and risk factors of cerebral microhemorrhages and superficial siderosis in cognitively unimpaired older adults: analysis from the CHARIOT\u2010PRO SubStudy"],"prefix":"10.1002","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6715-8027","authenticated-orcid":false,"given":"Sujin","family":"Kang","sequence":"first","affiliation":[{"name":"Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, Charing Cross Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1056-4718","authenticated-orcid":false,"given":"Dimitra","family":"Kafetsouli","sequence":"additional","affiliation":[{"name":"Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, Charing Cross Hospital  London UK"},{"name":"Directorate of Public Health, Imperial College NHS Healthcare Trust Charing Cross Hospital Site  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0272-8313","authenticated-orcid":false,"given":"Jamie","family":"Ford","sequence":"additional","affiliation":[{"name":"Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, Charing Cross Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janice","family":"Wong","sequence":"additional","affiliation":[{"name":"Johnson &amp; Johnson, Cambridge  Cambridge Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7175-8781","authenticated-orcid":false,"given":"Luc","family":"Bracoud","sequence":"additional","affiliation":[{"name":"Clario  Lyon France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joyce","family":"Suhy","sequence":"additional","affiliation":[{"name":"Clario  San\u00a0Mateo California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8852-940X","authenticated-orcid":false,"given":"Parthenia","family":"Giannakopoulou","sequence":"additional","affiliation":[{"name":"Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, Charing Cross Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7357-4692","authenticated-orcid":false,"given":"Chi","family":"Udeh\u2010Momoh","sequence":"additional","affiliation":[{"name":"School of Public Health Sciences Wake Forest University School of Medicine  Winston Salem North Carolina USA"},{"name":"Brain and Mind Institute Aga Khan University  Nairobi Kenya"},{"name":"Division of Clinical Geriatrics Centre for Alzheimer Research Karolinska Institutet  Solna Sweden"},{"name":"Sheffield Institute for Translational Neuroscience (SITraN) University of Sheffield, Broomhall  Sheffield UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9797-2188","authenticated-orcid":false,"given":"Tom C.","family":"Russ","sequence":"additional","affiliation":[{"name":"Division of Psychiatry, Centre for Clinical Brain Sciences University of Edinburgh  Edinburgh UK"},{"name":"Alzheimer Scotland Dementia Research Centre University of Edinburgh  Edinburgh UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Craig","family":"Ritchie","sequence":"additional","affiliation":[{"name":"University of St. Andrews, North Haugh  St. Andrews UK"},{"name":"Scottish Brain Sciences, Scottish Gas Murrayfield Stadium  Edinburgh UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1785-1800","authenticated-orcid":false,"given":"Zoi","family":"Alexopoulou","sequence":"additional","affiliation":[{"name":"Merck Sharp &amp; Dohme  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristian","family":"Salinas","sequence":"additional","affiliation":[{"name":"Takeda Pharmaceutical Company Ltd.  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