Cerebral small vessel disease in community-dwelling older adults living in remote rural settings

Oscar H. Del Brutto, Robertino M. Mera, Bettsy Y. Recalde, Victor J. Del Brutto

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Purpose: Cerebral small vessel disease (cSVD) has been overlooked in remote settings. In this study, we aimed to assess the burden of neuroimaging biomarkers of cSVD and its association with risk factors in community-dwelling older adults residing in rural Ecuador. Methods: Brain MRIs were performed in 590 individuals aged ≥60 years living in three neighboring rural villages. MRI readings focused on white matter hyperintensities (WMH) of presumed vascular origin, deep cerebral microbleeds (CMB), enlarged basal ganglia-perivascular spaces (BG-PVS), and lacunes of presumed vascular origin. Mixed effects models for binary outcomes were fitted using WMH as the dependent variable. Results: The mean age of participants was 71.1 ± 8.5 years (57% women). Moderate-to-severe WMH were noticed in 172 individuals (29%), deep CMB in 49 (8%), >10 enlarged BG-PVS in 183 (31%), and lacunes in 67 (11%). All biomarkers of cSVD were associated with increasing age, lower levels of education, poor physical activity, and arterial hypertension. Neuroimaging evidence of cSVD was present in almost half of older adults living in remote settings. Conclusions: Prompt recognition of cSVD biomarkers and implementation of strategic interventions may prove cost-effective for reducing its burden in underserved communities.

Original languageEnglish (US)
Article number117016
JournalJournal of the Neurological Sciences
StatePublished - Sep 15 2020


  • Cerebral microbleeds
  • Cerebral small vessel disease
  • Enlarged basal ganglia perivascular spaces
  • Lacunes
  • Rural settings
  • White matter hyperintensities

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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