Summary: A new study links cognitive decline and memory loss to cerebral small vessel disease.
Source: Loyola University Health System.
Memory loss, language problems and other symptoms of cognitive decline are strongly associated with diseases of the small blood vessels in the brain, a study has found.
The study by senior author José Biller, MD, first author Victor Del Brutto, MD, and colleagues is published in the International Journal of Geriatric Psychiatry. Dr. Biller is chair of Loyola Medicine’s department of neurology. Dr. Del Brutto is a University of Chicago resident who did a neurology rotation at Loyola.
The study included 331 volunteers age 60 and older who live in Atahualpa, a small rural village in coastal Ecuador. The subjects were given cognitive tests and brain MRIs. The MRIs were examined for four main components of small vessel disease (SVD). These four components, which include evidence of microbleeds and minor strokes, then were added to create a total SVD score. The score ranges from zero points (no SVD) to 4 points (severe SVD).
The study found that that 61 percent of the subjects had zero points on the total SVD score, 20 percent had 1 point, 12 percent had 2 points, 5 percent had 3 points and 2 percent had 4 points. The higher the SVD score, the greater the cognitive decline. Researchers also found that each individual component of SVD predicted cognitive decline as well as the total SVD score did.
Cognitive decline was measured by a Spanish version of the Montreal Cognitive Assessment test. Subjects were asked to do basic cognitive tasks such as counting backwards from 100 by sevens, repeating back a list of words, identifying drawings of animals and naming in one minute as many words as possible that begin with N.
The finding that 39 percent of the older adults have at least one component of SVD indicates the condition is common in the region. This prevalence makes Atahualpa a suitable population for studying the effect of SVD on cognitive performance, researchers wrote.
SVD in the brain is a recognized cause of stroke and cognitive decline worldwide. The condition is an especial concern in Latin American countries, where it has been shown to be one of the most common mechanisms that cause strokes.
The study is part of the groundbreaking Atahualpa Project, a population-based study designed to reduce the increasing burden of strokes and other neurological disorders in rural Ecuador and similar communities in Latin America. Many Atahualpa residents have enrolled in studies of risk factors for common diseases, especially neurological and cardiovascular diseases. More than 95 percent of Atahualpa’s population belongs to the native/Mestizo ethnic group, and the villagers have similar diets and lifestyles, making them suitable subjects for population studies.
One of the SVD study’s authors, Mauricio Zambrano, is coordinator of the Atahualpa Project. Two other co-authors, Victor Del Brutto, MD, and Loyola vascular neurology fellow Jorge Ortiz, MD, are from Ecuador. The other co-authors are Atahualpa Project founder Oscar Del Brutto, MD, of the Universidad Espiritu Santo in Guayaquil, Ecuador and Robertino Mera, PhD, of the University of Vanderbilt Medical Center.
Source: Jim Ritter – Loyola University Health System
Image Source: NeuroscienceNews.com image is in the public domain.
Original Research: Abstract for “Total cerebral small vessel disease score and cognitive performance in community-dwelling older adults. Results from the Atahualpa Project” by Victor J. Del Brutto, Jorge G. Ortiz, Oscar H. Del Brutto, Robertino M. Mera, Mauricio Zambrano, and José Biller in International Journal of Geriatric Psychiatry. Published online May 36 2017 doi:10.1002/gps.4747
[cbtabs][cbtab title=”MLA”]Loyola University Health System “Memory Loss and Other Cognitive Decline Linked to Blood Vessel Disease in the Brain.” NeuroscienceNews. NeuroscienceNews, 6 June 2017.
<https://neurosciencenews.com/blood-vessel-memory-loss-6842/>.[/cbtab][cbtab title=”APA”]Loyola University Health System (2017, June 6). Memory Loss and Other Cognitive Decline Linked to Blood Vessel Disease in the Brain. NeuroscienceNew. Retrieved June 6, 2017 from https://neurosciencenews.com/blood-vessel-memory-loss-6842/[/cbtab][cbtab title=”Chicago”]Loyola University Health System “Memory Loss and Other Cognitive Decline Linked to Blood Vessel Disease in the Brain.” https://neurosciencenews.com/blood-vessel-memory-loss-6842/ (accessed June 6, 2017).[/cbtab][/cbtabs]
Abstract
Total cerebral small vessel disease score and cognitive performance in community-dwelling older adults. Results from the Atahualpa Project
Objective
Cerebral small vessel disease (SVD) is inversely associated with cognitive performance. However, whether the total SVD score is a better predictor of poor cognitive performance than individual signatures of SVD is inconclusive. We aimed to estimate the combined and independent predictive power of these MRI findings.
Methods
Atahualpa residents aged ≥60 years underwent brain MRI. Cognitive performance was measured by the Montreal Cognitive Assessment (MoCA). The presence of moderate-to-severe white matter hyperintensities, deep cerebral microbleeds, lacunar infarcts, and >10 enlarged perivascular spaces was added for estimating the total SVD score ranging from 0 to 4 points. Montreal Cognitive Assessment predictive models were fitted to assess how well the total SVD score or each of its components predicts cognitive performance.
Results
Of 351 eligible candidates, 331 (94%) were included. The total SVD score was 0 points in 202 individuals (61%), 1 point in 67 (20%), 2 points in 40 (12%), 3 points in 15 (5%), and 4 points in seven (2%). A generalized lineal model showed an inverse relationship between the total SVD score and the MoCA (p = 0.015). The proportion of variance in the MoCA score explained by the SVD score was 32.8% (R2 = 0.328). This predictive power was similar for white matter hyperintensities (R2 = 0.306), microbleeds (R2 = 0.313), lacunar infarcts (R2 = 0.323), and perivascular spaces (R2 = 0.313).
Conclusions
This study shows a significant association between the SVD score and worse cognitive performance. The SVD score is a predictor of poor cognitive performance. This predictive power is not better than that of isolated neuroimaging signatures of SVD.
“Total cerebral small vessel disease score and cognitive performance in community-dwelling older adults. Results from the Atahualpa Project” by Victor J. Del Brutto, Jorge G. Ortiz, Oscar H. Del Brutto, Robertino M. Mera, Mauricio Zambrano, and José Biller in International Journal of Geriatric Psychiatry. Published online May 36 2017 doi:10.1002/gps.4747
