Lack of attention points to earlier warning signs of silent spills between people at risk


Lack of attention points to earlier warning signs of silent spills between people at risk

A diagram of a brain with small vessel cerebral disease, also known as silent stroke. Credit: Provided by the Rotman Research Institute of Baycrest

Adults who find that they frequently lose their line of reasoning or are often disoriented may actually be exhibiting previous symptoms of small vessel disease, also known as a "silent stroke," a new study suggests.

Researchers have found that individuals with white matter brain damage caused by silent strokes reported a lack of attention and were more often distracted in day-to-day tasks, according to an article published recently in the journal. Neurobiology of Aging. Despite these complaints, about half of the people with white-matter damage identified scored within the normal range in formal laboratory assessments of attention and executive function (a person's ability to plan, stay organized, and stay focused on overall goals).

"Our results indicate that in many cases of people who were at greater risk for silent stroke and had one, they saw a noticeable difference in their ability to stay focused even before the symptoms became detectable through a neuropsychological test, "says Ayan Dey, lead author of the paper and a graduate student at the Rotman Research Institute in Baycrest (RRI) and the University of Toronto. "If a person feels that this may be the case, concerns should be brought to a doctor, especially if the person has a health condition or lifestyle that puts them at greater risk of stroke or heart disease."

Small vessel disease is one of the most common neurological disorders of aging. This type of stroke and changes in cerebral blood flow (vascular changes) are linked to the development of vascular dementia and an increased risk of Alzheimer's disease and other dementias.

Spills are "silent" as they do not cause great lasting changes observed with an obvious stroke, such as affecting a person's speaking ability or paralysis. Despite the lack of obvious symptoms, the disease of small cerebral vessels causes damage to the white matter of the brain (responsible for communication between regions), which can cause cognitive and memory problems over time.

Typically, this type of stroke is discovered incidentally through MRI scans or once brain damage has worsened, says Dey.

"There are no effective treatments for Alzheimer's disease, but vascular changes in the brain can be prevented or reduced through cessation of smoking, exercise, diet and stress management, as well as keeping blood pressure, diabetes and cholesterol under control," he says. Dr. Brian Levine, senior author on the paper, RRI senior scientist and professor of Psychology and Neurology at the University of Toronto. "With the correct diagnosis, these interventions and changes in lifestyle give the elderly who are at risk of cognitive decline some options to maintain brain health."

The study looked at the results of 54 adults (ages 55 to 80) who also had at least one risk factor for stroke, such as high blood pressure, high cholesterol, diabetes, sleep apnea, history of smoking, past mini traits and old age above 75.

Researchers had their brains scanned by magnetic resonance imaging, and scientists looked at brain tissue damage, specifically white matter, to determine lesions caused by small vessel brain disease. They also participated in several neurocognitive tests and questionnaires that assessed their attention and executive function.

Following this study, the researchers will analyze functional brain images and electrical brain activity of the participants to analyze the differences in brain networks. They hope to find out why some people still manage to perform well on cognitive assessments, despite damage to the brain.

"The question that remains is whether overcoming these changes in the brain is a natural ability that some people have or if this is something that can be built over time," says Dey. "If it's something that can be developed, is it something we can train?"

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More information:
Ayan K. Dey et al., Cognitive heterogeneity among community elders living with small vessel cerebral disease, Neurobiology of Aging (2019) DOI: 10.1016 / j.neurobiolaging.2018.12.011

Provided by
Baycrest Center for Geriatric Care

Lack of attention points to earlier warning signs of silent spills among people at risk (2019, Feb. 6)
recovered on February 6, 2019

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