A new study by scientists at Columbia University Medical Center in New York has found that “silent strokes” are associated with memory loss in the elderly, suggesting that stroke-prevention may help stave off memory loss in the elderly, according to the study authors.
“Silent Strokes” are essentially blood clots that occur in the brain without being detected in about one out of four older adults. These silent strokes leave small spots of dead brain cells, which the new study found associated with memory loss, whether or not shrinkage of the hippocampus area of the brain (normally associated with age-related memory decline) is also present.
“The new aspect of this study of memory loss in the elderly is that it examines silent strokes and hippocampal shrinkage simultaneously,” said the study’s lead author, Adam M. Brickman, PhD, of the Taub Institute for Research on Alzheimer’s Disease and the Aging Brain at Columbia University Medical Center in New York.
In the study, researchers conducted MRI brain scans on a group of 658 people ages 65 and older who were free of dementia. Cortical and subcortical infarcts (silent strokes) were identified, and hippocampal and relative brain volumes were calculated following standard protocols. A total of 174 of the participants were found to have had silent strokes. All of the study participants underwent a comprehensive battery of neuropsychological memory tests measuring their memory, language, speed at processing information and visual perception.
The scientists analyzed the data to determine the extent of association between cognitive performance in areas of memory, language, processing speed, and visuospatial ability and (i) subcortical infarcts (silent strokes), on the one hand, and (ii) hippocampus shrinkage and relative brain volume, on the other hand.
The researchers reported several findings:
1. As previously known, shrinkage of the hippocampus volume of the brain was associated with poorer memory.
2. The presence of silent strokes was associated with a smaller hippocampus.
3. But, perhaps surprisingly, silent strokes were also associated with poorer memory and cognitive performance in all other domains, independently — that is, whether or not there was also shrinkage in volume of the hippocampus, which is the memory center of the brain.
“Both hippocampal volume and brain infarcts [silent strokes] independently contribute to memory performance in elderly individuals without dementia,” the authors concluded.
“Given that conditions like Alzheimer’s disease are defined mainly by memory problems, our results may lead to further insight into what causes symptoms and the development of new interventions for prevention. Since silent strokes and the volume of the hippocampus appeared to be associated with memory loss separately in our study, our results also support stroke prevention as a means for staving off memory problems,” said Dr. Adam M. Brickman, the study’s lead author.
The study was supported by the National Institutes of Health.
The full study report is available online in the January 3, 2012 issue of Neurology®, the medical journal of the American Academy of Neurology. The American Academy of Neurology (AAN) is an association of 24,000 neurologists and neuroscience professionals. “A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, brain injury, Parkinson’s disease and epilepsy,” explains the AAN.
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