Wednesday, June 7, 2017

Memory Loss and Other Cognitive Decline Linked to Blood Vessel Disease in the Brain

MAYWOOD, IL –  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 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.

The study is titled, “Total cerebral small vessel disease score and cognitive performance in community-dwelling older adults. Results from the Atahualpa Project.”

About Loyola University Health System

Loyola University Health System (LUHS) is a member of Trinity Health. Based in the western suburbs of Chicago, LUHS is a quaternary care system that includes Loyola University Medical Center (LUMC), located on a 61-acre campus in Maywood, Gottlieb Memorial Hospital (GMH), on a 36-acre campus in Melrose Park, and convenient locations offering primary and specialty care services throughout Cook, Will and DuPage counties. At the heart of LUMC is a 547-licensed-bed hospital that houses the Center for Heart & Vascular Medicine, the Cardinal Bernardin Cancer Center, a Level 1 trauma center, a burn center, a children's hospital, Loyola Outpatient Center, and Loyola Oral Health Center. The campus also is home to Loyola University Chicago Stritch School of Medicine, Loyola University Chicago Marcella Niehoff School of Nursing and the Loyola Center for Fitness. The GMH campus includes a 254-licensed-bed community hospital, a Professional Office Building with 150 private practice clinics, an adult day care program, the Gottlieb Center for Fitness, the Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park.

Trinity Health is one of the largest multi-institutional Catholic health care delivery systems in the nation. It serves people and communities in 22 states from coast to coast with 93 hospitals, and 120 continuing care locations — including home care, hospice, PACE and senior living facilities — that provide nearly 2.5 million visits annually.