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.

中文翻译：

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居住在偏远农村地区的社区老年人的脑小血管病

目的 偏远地区忽视了脑小血管病 (cSVD)。在这项研究中，我们旨在评估 cSVD 神经影像生物标志物的负担及其与居住在厄瓜多尔农村社区老年人的风险因素的关联。方法 对居住在三个邻近农村的 590 名年龄≥60 岁的人进行了脑部 MRI 扫描。MRI 读数侧重于推测血管来源的白质高信号 (WMH)、深部脑微出血 (CMB)、扩大的基底神经节血管周围间隙 (BG-PVS) 和推测血管来源的腔隙。使用 WMH 作为因变量拟合二元结果的混合效应模型。结果 参与者的平均年龄为 71.1 ± 8.5 岁（57% 为女性）。172 人 (29%) 发现中度至重度 WMH，49 人 (8%) 发现深度 CMB，> 183 例 (31%) 中 10 处扩大的 BG-PVS，以及 67 例 (11%) 中的腔隙。cSVD 的所有生物标志物都与年龄增长、受教育程度低、体力活动差和动脉高血压有关。生活在偏远地区的老年人中，几乎有一半存在 cSVD 的神经影像学证据。结论 及时识别 cSVD 生物标志物和实施战略干预措施可能证明在减少服务不足社区的负担方面具有成本效益。