High Prevalence of Cerebrovascular Calcifications and Clinical Correlates in Indigenous Bolivian...

Area of Science:

• Neurology
• Vascular Biology
• Epidemiology

Background:

• Intracranial arteriosclerosis is a known risk factor for neurological disorders like stroke and dementia.
• Previous research on intracranial arteriosclerosis has primarily focused on industrialized populations.
• The prevalence and clinical significance of intracranial vascular calcifications in subsistence populations remain largely unknown.

Purpose of the Study:

• To determine the prevalence of intracranial vascular calcifications in Bolivian indigenous populations (Tsimane and Moseten).
• To investigate the association of these calcifications with demographic factors, brain atrophy, cognitive performance, and clinical symptoms.

Main Methods:

• A population-based study involving 1232 individuals from the Tsimane and Moseten communities in the Bolivian Amazon (2017-2019).
• Computed tomography (CT) scans were used to assess vascular calcifications in intracranial arteries (internal carotid, vertebral, lenticulostriate).
• Analysis included demographic data, brain atrophy measures, cognitive assessments, and clinical evaluations.

Main Results:

• Over 90% of participants exhibited intracranial vascular calcifications, a higher prevalence than observed in age-equivalent industrialized populations.
• Calcifications were significantly associated with increased age, brain atrophy, poorer cognitive performance, and parkinsonian symptoms.
• These findings were noted despite a physically active lifestyle and low rates of traditional cardiovascular risk factors.

Conclusions:

• Intracranial vascular calcifications are common in Bolivian Amerindian populations, even with a subsistence lifestyle and low cardiovascular disease burden.
• This suggests that factors beyond traditional cardiovascular risk factors contribute to intracranial arteriosclerosis in these populations.
• The findings may indicate a novel dementia phenotype associated with unique etiological pathways.