{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T20:01:22Z","timestamp":1772740882112,"version":"3.50.1"},"reference-count":72,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,4]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>The long-term cognitive consequences of calcified neurocysticercosis (NCC) remain poorly understood. This population-based study investigates cognitive trajectories in individuals with calcified NCC in coastal Ecuador. Utilizing repeated Montreal Cognitive Assessment (MoCA) screenings, the study evaluates whether calcified NCC independently contributes to cognitive decline and the role of hippocampal atrophy (HA) in this context. Among 720 community dwellers ages 40 years old and older, 85 (12%) had calcified NCC. The mean interval between baseline and first follow-up MoCA was 3.27 \u00b1 1.07 years and between baseline and second follow-up MoCA was 10.87 \u00b1 1.22 years. Of 720 participants, 617 (86%) completed the first follow-up MoCA, and 464 (75%) of them also had the subsequent follow-up MoCA. Proportions of NCC patients included in follow-ups were consistent with their representation at baseline. Baseline MoCA scores (\u03b2: 0.40; 95% CI: \u22120.48 to 1.29) or rates of MoCA decline at follow-up visits (\u03b2: 0.17; 95% CI: \u22120.67 to 1.0) did not differ significantly between NCC and non-NCC participants after adjusting for relevant covariates. The magnetic resonance imaging substudy showed that 31 of 83 NCC cases and 40 of 283 controls had HA (adjusted odds ratio: 2.63; 95% CI: 1.15 to 4.11). Additionally, HA was significantly associated with lower MoCA scores at baseline (\u03b2: \u22121.86; 95% CI: \u22122.98 to \u22120.74) and follow-up (\u03b2: \u22122.76; 95% CI: \u22123.83 to \u22121.69). These results suggest that calcified NCC alone was not associated with cognitive decline over time. However, NCC-associated HA emerged as a major determinant of poor cognitive performance.<\/jats:p>","DOI":"10.4269\/ajtmh.25-0682","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T16:23:39Z","timestamp":1769531019000},"page":"503-510","source":"Crossref","is-referenced-by-count":0,"title":["Trajectories of Cognitive Decline in Patients with Calcified Neurocysticercosis: A Population-Based, Prospective, Longitudinal Study in a Highly Endemic Setting"],"prefix":"10.4269","volume":"114","author":[{"given":"Oscar H.","family":"Del Brutto","sequence":"first","affiliation":[{"name":"School of Medicine, Universidad Esp\u00edritu Santo\u2013Ecuador, Samborond\u00f3n, Ecuador;"},{"name":"Research Center, Universidad Esp\u00edritu Santo\u2013Ecuador, Samborond\u00f3n, Ecuador;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denisse A.","family":"Rumbea","sequence":"additional","affiliation":[{"name":"Research Center, Universidad Esp\u00edritu Santo\u2013Ecuador, Samborond\u00f3n, Ecuador;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilio E.","family":"Arias","sequence":"additional","affiliation":[{"name":"Research Center, Universidad Esp\u00edritu Santo\u2013Ecuador, Samborond\u00f3n, Ecuador;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robertino M.","family":"Mera","sequence":"additional","affiliation":[{"name":"Biostatistics\/Epidemiology, Freenome, Inc., South San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Lancet Neurol","first-page":"1202","article-title":"Clinical symptoms, diagnosis, and treatment of neurocysticercosis","volume":"13","author":"Garc\u00eda","year":"2014"},{"key":"b2","series-title":"Curr Opin Infect Dis","first-page":"334","article-title":"Brain calcification because of neurocysticercosis: A vast field to be explored","volume":"33","author":"Bustos","year":"2020"},{"key":"b3","series-title":"Expert Rev Anti Infect Ther","first-page":"1073","article-title":"Management of calcified cysticerci in the brain parenchyma: Treating the dead parasite","volume":"22","author":"Del Brutto","year":"2024"},{"key":"b4","series-title":"Am J Trop Med Hyg","first-page":"1187","article-title":"Calcified neurocysticercosis: Understanding dead (not necessarily inactive) parasites","volume":"112","author":"Coyle","year":"2025"},{"key":"b5","series-title":"PloS Negl Trop Dis","first-page":"e2480","article-title":"Epilepsy and neurocysticercosis in Latin America: A systematic review and meta-analysis","volume":"7","author":"Bruno","year":"2013"},{"key":"b6","series-title":"PloS Negl Trop Dis","first-page":"e0005153","article-title":"Systematic review and meta-analysis estimating association of cysticercosis and neurocysticercosis with epilepsy","volume":"11","author":"Debacq","year":"2017"},{"key":"b7","series-title":"Epilepsia Open","first-page":"513","article-title":"Epilepsy and neurocysticercosis in rural areas of the Bolivian Chaco: What has changed during the last 30 years?","volume":"9","author":"Nicoletti","year":"2024"},{"key":"b8","series-title":"Neurology","first-page":"e209865","article-title":"Seizures and epilepsy in association with neurocysticercosis: A nosologic proposal","volume":"103","author":"Singh","year":"2024"},{"key":"b9","series-title":"Epilepsy Behav","first-page":"558","article-title":"Cognitive performance of patients with epilepsy and calcified neurocysticercotic lesions: A case-control study","volume":"2","author":"Boppr\u00e9","year":"2001"},{"key":"b10","series-title":"Neurology","first-page":"1288","article-title":"Cognitive impairment and dementia in neurocysticercosis: A cross-sectional controlled study","volume":"74","author":"Campi de Andrade","year":"2010"},{"key":"b11","series-title":"Neurology","first-page":"861","article-title":"Spectrum of cognitive impairment in neurocysticercosis: Differences according to disease phase","volume":"78","author":"Rodrigues","year":"2012"},{"key":"b12","series-title":"J Neurol Neurosurg Psychiatry","first-page":"1080","article-title":"Cognitive performance of patients with mesial temporal lobe epilepsy and incidental calcified neurocysticercosis","volume":"76","author":"Terra-Bustamante","year":"2005"},{"key":"b13","series-title":"Am J Trop Med Hyg","first-page":"323","article-title":"The association between calcified neurocysticercosis and cognitive performance: A case-control study nested to a population-based cohort","volume":"100","author":"Del Brutto","year":"2019"},{"key":"b14","series-title":"Clin Neurol Neurosurg","first-page":"109181","article-title":"Frequency and characteristics of cognitive impairment in individuals with calcified neurocysticercosis","volume":"258","author":"Vasquez-Baiocchi","year":"2025"},{"key":"b15","series-title":"PloS Negl Trop Dis","first-page":"e1493","article-title":"Cognitive changes and quality of life in neurocysticercosis: A longitudinal study","volume":"6","author":"Wallin","year":"2012"},{"key":"b16","series-title":"Epilepsia","first-page":"1955","article-title":"On the relationship between calcified neurocysticercosis and epilepsy in an endemic village: A large-scale, computed tomography-based population study in rural Ecuador","volume":"58","author":"Del Brutto","year":"2017"},{"key":"b17","series-title":"Am J Trop Med Hyg","first-page":"776","article-title":"Spontaneously arrested transmission of cysticercosis in a highly endemic village with a very low migration rate","volume":"98","author":"Del Brutto","year":"2018"},{"key":"b18","series-title":"Revista Ecuatoriana Neurologia","first-page":"17","article-title":"Estudio poblacional de prevalencia de cisticercosis porcina en Atahualpa, Ecuador: metodolog\u00eda y definiciones operacionales","volume":"26","author":"Del Brutto","year":"2017"},{"key":"b19","series-title":"Lancet","first-page":"1453","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies","volume":"370","author":"von Elm","year":"2007"},{"key":"b20","series-title":"J Neurol Sci","first-page":"202","article-title":"Revised diagnostic criteria for neurocysticercosis","volume":"372","author":"Del Brutto","year":"2017"},{"key":"b21","series-title":"J Am Geriatr Soc","first-page":"695","article-title":"The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment","volume":"53","author":"Nasreddine","year":"2005"},{"key":"b22","series-title":"Int J Geriatr Psychiatry","first-page":"813","article-title":"Applicability of the MoCA-S test in populations with little education in Colombia","volume":"28","author":"G\u00f3mez","year":"2013"},{"key":"b23","series-title":"J Geriatr Psychiatry Neurol","first-page":"104","article-title":"Brief screening for mild cognitive impairment in elderly outpatient clinic: Validation of the Korean Version of the Montreal Cognitive Assessment","volume":"21","author":"Lee","year":"2008"},{"key":"b24","series-title":"Am J Trop Med Hyg","first-page":"64","article-title":"Calcified neurocysticercosis associates with hippocampal atrophy: A population-based study","volume":"92","author":"Del Brutto","year":"2015"},{"key":"b25","series-title":"J Neurol Neurosurg Psychiatry","first-page":"967","article-title":"Atrophy of medial temporal lobes on MRI in \u201cprobable\u201d Alzheimer\u2019s disease and normal ageing: Diagnostic value and neuropsychological correlates","volume":"55","author":"Scheltens","year":"1992"},{"key":"b26","series-title":"Int J Geriatr Psychiatry","first-page":"447","article-title":"Clinical and neuroimaging risk factors for cognitive decline in community-dwelling older adults living in rural Ecuador. A population-based prospective cohort study","volume":"34","author":"Del Brutto","year":"2019"},{"key":"b27","series-title":"J Community Health","first-page":"1097","article-title":"Edentulism associates with worse cognitive performance in community-dwelling elders in rural Ecuador: Results of the Atahualpa Project","volume":"39","author":"Del Brutto","year":"2014"},{"key":"b28","series-title":"Geriatr Gerontol Int","first-page":"508","article-title":"Influence of depression, anxiety and stress on cognitive performance in community-dwelling older adults living in rural Ecuador: Results of the Atahualpa Project","volume":"15","author":"Del Brutto","year":"2015"},{"key":"b29","series-title":"J Community Health","first-page":"82","article-title":"Oily fish intake and cognitive performance in community-dwelling older adults: The Atahualpa Project","volume":"41","author":"Del Brutto","year":"2016"},{"key":"b30","series-title":"Int J Infect Dis","first-page":"226","article-title":"SARS-CoV-2-related mortality in a rural Latin American population","volume":"99","author":"Del Brutto","year":"2020"},{"key":"b31","series-title":"Curr Neurol Neurosci Rep","first-page":"1","article-title":"Update on cysticercosis epileptogenesis: The role of the hippocampus","volume":"16","author":"Del Brutto","year":"2016"},{"key":"b32","series-title":"Brain Pathol","first-page":"425","article-title":"Axonal swelling and spheroids: A new insight into the pathology of neurocysticercosis","volume":"29","author":"Mejia Maza","year":"2019"},{"key":"b33","series-title":"PLoS Negl Trop Dis","first-page":"e0004869","article-title":"Perilesional inflammation in neurocysticercosis\u2014Relationship between contrast-enhanced magnetic resonance imaging, Evans blue staining and histopathology in the pig model","volume":"10","author":"Cangalaya","year":"2016"},{"key":"b34","series-title":"Arch Clin Neuropsychol","first-page":"165","article-title":"Montreal Cognitive Assessment: Influences of sociodemographic and health variables","volume":"27","author":"Freitas","year":"2012"},{"key":"b35","series-title":"Trop Med Int Health","first-page":"1014","article-title":"Neurocysticercosis: Is serology useful in the absence of brain imaging?","volume":"17","author":"Garcia","year":"2012"},{"key":"b36","series-title":"Neuroradiology","first-page":"1321","article-title":"Is radiological evaluation as good as computer-based volumetry to assess hippocampal atrophy in Alzheimer\u2019s disease?","volume":"54","author":"Boutet","year":"2012"},{"key":"b1","series-title":"Lancet Neurol","first-page":"1202","article-title":"Clinical symptoms, diagnosis, and treatment of neurocysticercosis","volume":"13","author":"Garc\u00eda","year":"2014"},{"key":"b2","series-title":"Curr Opin Infect Dis","first-page":"334","article-title":"Brain calcification because of neurocysticercosis: A vast field to be explored","volume":"33","author":"Bustos","year":"2020"},{"key":"b3","series-title":"Expert Rev Anti Infect Ther","first-page":"1073","article-title":"Management of calcified cysticerci in the brain parenchyma: Treating the dead parasite","volume":"22","author":"Del Brutto","year":"2024"},{"key":"b4","series-title":"Am J Trop Med Hyg","first-page":"1187","article-title":"Calcified neurocysticercosis: Understanding dead (not necessarily inactive) parasites","volume":"112","author":"Coyle","year":"2025"},{"key":"b5","series-title":"PloS Negl Trop Dis","first-page":"e2480","article-title":"Epilepsy and neurocysticercosis in Latin America: A systematic review and meta-analysis","volume":"7","author":"Bruno","year":"2013"},{"key":"b6","series-title":"PloS Negl Trop Dis","first-page":"e0005153","article-title":"Systematic review and meta-analysis estimating association of cysticercosis and neurocysticercosis with epilepsy","volume":"11","author":"Debacq","year":"2017"},{"key":"b7","series-title":"Epilepsia Open","first-page":"513","article-title":"Epilepsy and neurocysticercosis in rural areas of the Bolivian Chaco: What has changed during the last 30 years?","volume":"9","author":"Nicoletti","year":"2024"},{"key":"b8","series-title":"Neurology","first-page":"e209865","article-title":"Seizures and epilepsy in association with neurocysticercosis: A nosologic proposal","volume":"103","author":"Singh","year":"2024"},{"key":"b9","series-title":"Epilepsy Behav","first-page":"558","article-title":"Cognitive performance of patients with epilepsy and calcified neurocysticercotic lesions: A case-control study","volume":"2","author":"Boppr\u00e9","year":"2001"},{"key":"b10","series-title":"Neurology","first-page":"1288","article-title":"Cognitive impairment and dementia in neurocysticercosis: A cross-sectional controlled study","volume":"74","author":"Campi de Andrade","year":"2010"},{"key":"b11","series-title":"Neurology","first-page":"861","article-title":"Spectrum of cognitive impairment in neurocysticercosis: Differences according to disease phase","volume":"78","author":"Rodrigues","year":"2012"},{"key":"b12","series-title":"J Neurol Neurosurg Psychiatry","first-page":"1080","article-title":"Cognitive performance of patients with mesial temporal lobe epilepsy and incidental calcified neurocysticercosis","volume":"76","author":"Terra-Bustamante","year":"2005"},{"key":"b13","series-title":"Am J Trop Med Hyg","first-page":"323","article-title":"The association between calcified neurocysticercosis and cognitive performance: A case-control study nested to a population-based cohort","volume":"100","author":"Del Brutto","year":"2019"},{"key":"b14","series-title":"Clin Neurol Neurosurg","first-page":"109181","article-title":"Frequency and characteristics of cognitive impairment in individuals with calcified neurocysticercosis","volume":"258","author":"Vasquez-Baiocchi","year":"2025"},{"key":"b15","series-title":"PloS Negl Trop Dis","first-page":"e1493","article-title":"Cognitive changes and quality of life in neurocysticercosis: A longitudinal study","volume":"6","author":"Wallin","year":"2012"},{"key":"b16","series-title":"Epilepsia","first-page":"1955","article-title":"On the relationship between calcified neurocysticercosis and epilepsy in an endemic village: A large-scale, computed tomography-based population study in rural Ecuador","volume":"58","author":"Del Brutto","year":"2017"},{"key":"b17","series-title":"Am J Trop Med Hyg","first-page":"776","article-title":"Spontaneously arrested transmission of cysticercosis in a highly endemic village with a very low migration rate","volume":"98","author":"Del Brutto","year":"2018"},{"key":"b18","series-title":"Revista Ecuatoriana Neurologia","first-page":"17","article-title":"Estudio poblacional de prevalencia de cisticercosis porcina en Atahualpa, Ecuador: metodolog\u00eda y definiciones operacionales","volume":"26","author":"Del Brutto","year":"2017"},{"key":"b19","series-title":"Lancet","first-page":"1453","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies","volume":"370","author":"von Elm","year":"2007"},{"key":"b20","series-title":"J Neurol Sci","first-page":"202","article-title":"Revised diagnostic criteria for neurocysticercosis","volume":"372","author":"Del Brutto","year":"2017"},{"key":"b21","series-title":"J Am Geriatr Soc","first-page":"695","article-title":"The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment","volume":"53","author":"Nasreddine","year":"2005"},{"key":"b22","series-title":"Int J Geriatr Psychiatry","first-page":"813","article-title":"Applicability of the MoCA-S test in populations with little education in Colombia","volume":"28","author":"G\u00f3mez","year":"2013"},{"key":"b23","series-title":"J Geriatr Psychiatry Neurol","first-page":"104","article-title":"Brief screening for mild cognitive impairment in elderly outpatient clinic: Validation of the Korean Version of the Montreal Cognitive Assessment","volume":"21","author":"Lee","year":"2008"},{"key":"b24","series-title":"Am J Trop Med Hyg","first-page":"64","article-title":"Calcified neurocysticercosis associates with hippocampal atrophy: A population-based study","volume":"92","author":"Del Brutto","year":"2015"},{"key":"b25","series-title":"J Neurol Neurosurg Psychiatry","first-page":"967","article-title":"Atrophy of medial temporal lobes on MRI in \u201cprobable\u201d Alzheimer\u2019s disease and normal ageing: Diagnostic value and neuropsychological correlates","volume":"55","author":"Scheltens","year":"1992"},{"key":"b26","series-title":"Int J Geriatr Psychiatry","first-page":"447","article-title":"Clinical and neuroimaging risk factors for cognitive decline in community-dwelling older adults living in rural Ecuador. A population-based prospective cohort study","volume":"34","author":"Del Brutto","year":"2019"},{"key":"b27","series-title":"J Community Health","first-page":"1097","article-title":"Edentulism associates with worse cognitive performance in community-dwelling elders in rural Ecuador: Results of the Atahualpa Project","volume":"39","author":"Del Brutto","year":"2014"},{"key":"b28","series-title":"Geriatr Gerontol Int","first-page":"508","article-title":"Influence of depression, anxiety and stress on cognitive performance in community-dwelling older adults living in rural Ecuador: Results of the Atahualpa Project","volume":"15","author":"Del Brutto","year":"2015"},{"key":"b29","series-title":"J Community Health","first-page":"82","article-title":"Oily fish intake and cognitive performance in community-dwelling older adults: The Atahualpa Project","volume":"41","author":"Del Brutto","year":"2016"},{"key":"b30","series-title":"Int J Infect Dis","first-page":"226","article-title":"SARS-CoV-2-related mortality in a rural Latin American population","volume":"99","author":"Del Brutto","year":"2020"},{"key":"b31","series-title":"Curr Neurol Neurosci Rep","first-page":"1","article-title":"Update on cysticercosis epileptogenesis: The role of the hippocampus","volume":"16","author":"Del Brutto","year":"2016"},{"key":"b32","series-title":"Brain Pathol","first-page":"425","article-title":"Axonal swelling and spheroids: A new insight into the pathology of neurocysticercosis","volume":"29","author":"Mejia Maza","year":"2019"},{"key":"b33","series-title":"PLoS Negl Trop Dis","first-page":"e0004869","article-title":"Perilesional inflammation in neurocysticercosis\u2014Relationship between contrast-enhanced magnetic resonance imaging, Evans blue staining and histopathology in the pig model","volume":"10","author":"Cangalaya","year":"2016"},{"key":"b34","series-title":"Arch Clin Neuropsychol","first-page":"165","article-title":"Montreal Cognitive Assessment: Influences of sociodemographic and health variables","volume":"27","author":"Freitas","year":"2012"},{"key":"b35","series-title":"Trop Med Int Health","first-page":"1014","article-title":"Neurocysticercosis: Is serology useful in the absence of brain imaging?","volume":"17","author":"Garcia","year":"2012"},{"key":"b36","series-title":"Neuroradiology","first-page":"1321","article-title":"Is radiological evaluation as good as computer-based volumetry to assess hippocampal atrophy in Alzheimer\u2019s disease?","volume":"54","author":"Boutet","year":"2012"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/114\/3\/article-p503.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/114\/3\/article-p503.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/114\/3\/article-p503.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T19:11:59Z","timestamp":1772737919000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/114\/3\/article-p503.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,4]]},"references-count":72,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.25-0682","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,4]]}}}