High frequency of silent brain infarcts associated with cognitive deficits in an economically disadvantaged population

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorSQUARZONI, Paula
dc.contributor.authorTAMASHIRO-DURAN, Jaqueline H.
dc.contributor.authorDURAN, Fabio L. S.
dc.contributor.authorLEITE, Claudia C.
dc.contributor.authorWAJNGARTEN, Mauricio
dc.contributor.authorSCAZUFCA, Marcia
dc.contributor.authorMENEZES, Paulo R.
dc.contributor.authorLOTUFO, Paulo A.
dc.contributor.authorALVES, Tania C. T. F.
dc.contributor.authorBUSATTO, Geraldo F.
dc.date.accessioned2017-12-12T13:15:42Z
dc.date.available2017-12-12T13:15:42Z
dc.date.issued2017
dc.description.abstractOBJECTIVE: Using magnetic resonance imaging, we aimed to assess the presence of silent brain vascular lesions in a sample of apparently healthy elderly individuals who were recruited from an economically disadvantaged urban region (Sao Paulo, Brazil). We also wished to investigate whether the findings were associated with worse cognitive performance. METHODS: A sample of 250 elderly subjects (66-75 years) without dementia or neuropsychiatric disorders were recruited from predefined census sectors of an economically disadvantaged area of Sao Paulo and received structural magnetic resonance imaging scans and cognitive testing. A high proportion of individuals had very low levels of education (4 years or less, n= 185; 21 with no formal education). RESULTS: The prevalence of at least one silent vascular-related cortical or subcortical lesion was 22.8% (95% confidence interval, 17.7-28.5), and the basal ganglia was the most frequently affected site (63.14% of cases). The subgroup with brain infarcts presented significantly lower levels of education than the subgroup with no brain lesions as well as significantly worse current performance in cognitive test domains, including memory and attention (p<0.002). CONCLUSIONS: Silent brain infarcts were present at a substantially high frequency in our elderly sample from an economically disadvantaged urban region and were significantly more prevalent in subjects with lower levels of education. Covert cerebrovascular disease significantly contributes to cognitive deficits, and in the absence of magnetic resonance imaging data, this cognitive impairment may be considered simply related to ageing. Emphatic attention should be paid to potentially deleterious effects of vascular brain lesions in poorly educated elderly individuals from economically disadvantaged environments.
dc.description.indexMEDLINE
dc.description.sponsorshipWellcome Trust, UK [GR066133MA]
dc.description.sponsorshipFAPESP, Brazil [2004/15336-5, 2012/503296, 2013/03231-3]
dc.description.sponsorshipFAPESP-Brazil [2013/03231-3]
dc.description.sponsorshipCNPQ-Brazil
dc.identifier.citationCLINICS, v.72, n.8, p.474-480, 2017
dc.identifier.doi10.6061/clinics/2017(08)04
dc.identifier.eissn1980-5322
dc.identifier.issn1807-5932
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/24237
dc.language.isoeng
dc.publisherHOSPITAL CLINICAS, UNIV SAO PAULO
dc.relation.ispartofClinics
dc.rightsopenAccess
dc.rights.holderCopyright HOSPITAL CLINICAS, UNIV SAO PAULO
dc.subjectFramingham Coronary Heart Disease Risk
dc.subjectAgeing
dc.subjectEducational Level
dc.subjectCognition
dc.subjectSilent Brain Infarction
dc.subject.othercoronary-heart-disease
dc.subject.othersmall vessel disease
dc.subject.otherlacunar infarcts
dc.subject.otheralzheimers-disease
dc.subject.otherhigh prevalence
dc.subject.otherolder-adults
dc.subject.otherdementia
dc.subject.otherrisk
dc.subject.otherframingham
dc.subject.othereducation
dc.subject.wosMedicine, General & Internal
dc.titleHigh frequency of silent brain infarcts associated with cognitive deficits in an economically disadvantaged population
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.citation.scopus13
hcfmusp.contributor.author-fmusphcPAULA SQUARZONI DA SILVEIRA
hcfmusp.contributor.author-fmusphcJAQUELINE HATSUKO TAMASHIRO DURAN
hcfmusp.contributor.author-fmusphcFABIO LUIS DE SOUZA DURAN
hcfmusp.contributor.author-fmusphcCLAUDIA DA COSTA LEITE
hcfmusp.contributor.author-fmusphcMAURICIO WAJNGARTEN
hcfmusp.contributor.author-fmusphcMARCIA SCAZUFCA
hcfmusp.contributor.author-fmusphcPAULO ROSSI MENEZES
hcfmusp.contributor.author-fmusphcPAULO ANDRADE LOTUFO
hcfmusp.contributor.author-fmusphcTANIA CORREA DE TOLEDO FERRAZ ALVES
hcfmusp.contributor.author-fmusphcGERALDO BUSATTO FILHO
hcfmusp.description.beginpage474
hcfmusp.description.endpage480
hcfmusp.description.issue8
hcfmusp.description.volume72
hcfmusp.origemWOS
hcfmusp.origem.pubmed28954006
hcfmusp.origem.scieloSCIELO:S1807-59322017000800474
hcfmusp.origem.scopus2-s2.0-85030155126
hcfmusp.origem.wosWOS:000411803900004
hcfmusp.publisher.citySAO PAULO
hcfmusp.publisher.countryBRAZIL
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