1
|
Ribeiro FS, Crivelli L, Leist AK. Gender inequalities as contributors to dementia in Latin America and the Caribbean: what factors are missing from research? THE LANCET. HEALTHY LONGEVITY 2023:S2666-7568(23)00052-1. [PMID: 37182531 DOI: 10.1016/s2666-7568(23)00052-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/06/2023] [Accepted: 03/06/2023] [Indexed: 05/16/2023] Open
Abstract
The current knowledge of modifiable risk factors for dementia comes mainly from high-income countries. In Latin America and Caribbean countries, where the burden of gender and socioeconomic inequalities is greater than in high-income countries, the prevalence of dementia is also higher and disease onset is earlier, especially among women, even after adjustments for life expectancy. In this Personal View, we discuss socioeconomic modifiable risk factors for dementia established by previous studies and postulate further harmful and often hidden factors faced by women that might influence the gender-specific timing of onset and general prevalence of dementia. We emphasise some of the effects of gender roles, their direct and indirect effects on dementia, and how they disproportionately impact women. Finally, we highlight the importance of bringing hidden risk factors to open discussion to promote research with high-quality data and to encourage public policies to promote and preserve women's health.
Collapse
Affiliation(s)
- Fabiana S Ribeiro
- Department of Social Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg.
| | - Lucía Crivelli
- Department of Cognitive Neurology, FLENI, Buenos Aires, Argentina
| | - Anja K Leist
- Department of Social Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| |
Collapse
|
2
|
Piña-Escudero SD, Aguirre GA, Javandel S, Longoria-Ibarrola EM. Caregiving for Patients With Frontotemporal Dementia in Latin America. Front Neurol 2021; 12:665694. [PMID: 34305781 PMCID: PMC8292669 DOI: 10.3389/fneur.2021.665694] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 05/24/2021] [Indexed: 11/26/2022] Open
Abstract
Latin America is a vast heterogeneous territory where chronic diseases such as mild cognitive impairment or dementia are becoming higher. Frontotemporal dementia (FTD) prevalence in this region is estimated to be around 12-18 cases per thousand persons. However, this prevalence is underestimated given the lack of awareness of FTD even among healthcare professionals. Family members are responsible for the care of patients with FTD at home. These caregivers deliver care despite being ill-equipped and living in the context of austerity policies and social inequities. They often face unsurmountable financial and social burdens that are specific to the region. The most important step to support caregivers in Latin America is to increase awareness of the disease at all levels. Healthcare diplomacy is fundamental to create joint efforts that push policies forward to protect caregivers of FTD patients.
Collapse
Affiliation(s)
- Stefanie Danielle Piña-Escudero
- The Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United Statesand Trinity College, Dublin, Ireland
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Gloria Annette Aguirre
- The Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United Statesand Trinity College, Dublin, Ireland
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Shireen Javandel
- The Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United Statesand Trinity College, Dublin, Ireland
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Erika Mariana Longoria-Ibarrola
- The Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United Statesand Trinity College, Dublin, Ireland
- Instituto Nacional de Neurología y Neurocirugía José Velazco Suárez, Mexico City, Mexico
| |
Collapse
|
3
|
Hernández-Ledesma AL, Rodríguez-Méndez AJ, Gallardo-Vidal LS, García-Gasca T, Alatorre-Cruz JM, García-Solís P, López Reyes J, Solís-Saínz JC. Lipid profile: causal relationship on cognitive performance in multiple sclerosis? Mol Biol Rep 2020; 47:9667-9676. [PMID: 33259011 DOI: 10.1007/s11033-020-06011-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 11/16/2020] [Indexed: 12/16/2022]
Abstract
Although cognitive impairment (CI) is classically associated with aging, it has been proposed that neurological pathologies may increase the risk to suffer CI. Despite the evidence of an elevated prevalence of CI in patients with multiple sclerosis (MS), it is not considered among standard clinical evaluations, due the lack of specialists and time required. The aim of this study was to evaluate if lipid profile is associated with cognitive performance in persons with MS. Twenty patients with MS were evaluated. Montreal Cognitive Assessment (MoCA) was employed to determine cognitive performance. CI was observed in 85% of patients, with memory recall and language as the most affected domains. Despite biomarkers were mostly found within reference values, several correlations were observed. MoCA total score was correlated with cholesterol (r = - 0.468, p = 0.037) and LDL (r = - 0.453, p = 0.045). Visuospatial domain was correlated with LDL (r = - 0.493, p = 0.027). Attention domain correlated with triglycerides (r = - 0.455, p = 0.044) and cholesterol (r = - 0.549, p = 0.012). When the person reaches borderline levels of triglycerides, LDL and cholesterol a decrease in cognitive performance can be observed. The mechanism underlying this association has not been established still, it has been proposed that it could be linked with neuroinflammation, alterations in synapses and in the metabolism of amyloid-β protein. This study settles the potential importance that lipid profile could have on cognitive performance in MS. Further studies are needed to establish optimal levels and implication of lipid profile in the diagnosis and monitoring of cognitive performance in Mexican people with MS.
Collapse
Affiliation(s)
- Ana Laura Hernández-Ledesma
- Laboratorio de Neuroinmunoendocrinología, Departamento de Investigación Biomédica, Facultad de Medicina, Universidad Autónoma de Querétaro, Clavel #200. Prados de la Capilla. CP 76170, Santiago de Querétaro, México
| | - Adriana Jheny Rodríguez-Méndez
- Laboratorio de Neuroinmunoendocrinología, Departamento de Investigación Biomédica, Facultad de Medicina, Universidad Autónoma de Querétaro, Clavel #200. Prados de la Capilla. CP 76170, Santiago de Querétaro, México.
| | | | - Teresa García-Gasca
- Facultad de Ciencias Naturales, Universidad Autónoma de Querétaro, Santiago de Querétaro, México
| | | | - Pablo García-Solís
- Departamento de Investigación Biomédica, Facultad de Medicina, Universidad Autónoma de Querétaro, Santiago de Querétaro, México
| | - Julián López Reyes
- Facultad de Medicina, Clínica del Sistema Nervioso, Universidad Autónoma de Querétaro, Santiago de Querétaro, México
| | - Juan Carlos Solís-Saínz
- Departamento de Investigación Biomédica, Facultad de Medicina, Universidad Autónoma de Querétaro, Santiago de Querétaro, México
| |
Collapse
|
4
|
Reyes-Ortiz CA, Perez-Zepeda MU, Ocampo-Chaparro JM, Campo-Arias A, Borda MG, Holmes HM, Luque JS. Polyvictimization and Recurrent Falling in Older Ecuadorian Adults: The Mediation Role of Depressive Symptoms. J Aging Health 2020; 33:27-38. [PMID: 32877294 DOI: 10.1177/0898264320952916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective: To assess depressive symptoms as a mediator in the association between polyvictimization and recurrent falling. Methods: Using data from the Salud, Bienestar y Envejecimiento (Health, Well-being, and Aging) Ecuador Study, we analyzed community-dwelling adults 60 years and older (n = 5227). Recurrent falling was determined as ≥2 falls during the prior 12 months. Polyvictimization was determined as a history of ≥2 types of abuse. The mediator was depressive symptoms. Mediation analyses were based on the VanderWeele method. Results: Polyvictimization was significantly associated with higher odds of recurrent falling, and odds ratio (OR) = 1.45 (95% confidence intervals [CI] 1.20-1.76). Higher depressive symptoms increase the odds for recurrent falling (OR = 1.09 and 95% CI 1.07-1.11). Moreover, depressive symptoms were a significant mediator between polyvictimization and recurrent falling. The mediating effect was 28.4%. Discussion: Polyvictimization was associated with higher odds of recurrent falling, and this association was mediated by depressive symptoms.
Collapse
Affiliation(s)
- Carlos A Reyes-Ortiz
- Institute of Public Health, College of Pharmacy and Pharmaceutical Sciences, 15467Florida A&M University, FL, USA
| | - Mario U Perez-Zepeda
- Geriatric Medicine Research, Nova Scotia Health Authority, 12361Dalhousie University, Canada.,Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Facultad de Medicina, 27964Pontificia Universidad Javeriana, Colombia.,233936Instituto Nacional de Geriatría, Mexico.,Centro de Investigación en Ciencias de la Salud (CICSA), FCS, 27753Universidad Anáhuac México Campus Norte, México
| | - José M Ocampo-Chaparro
- 28006Universidad del Valle, Colombia.,Grupo Interinstitucional de Medicina Interna (GIMI 1), 67637Universidad Libre, Colombia
| | - Adalberto Campo-Arias
- Programa de Medicina, Facultad de Ciencias de la Salud, 469579Universidad del Magdalena, Colombia
| | - Miguel G Borda
- Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Facultad de Medicina, 27964Pontificia Universidad Javeriana, Colombia.,Centre for Age-Related Medicine (SESAM), 60496Stavanger University Hospital, Norway.,Faculty of Health Sciences, 56627University of Stavanger, Norway
| | - Holly M Holmes
- McGovern Medical School, Geriatric and Palliative Medicine Division, 12339University of Texas Health Science Center at Houston, TX, USA
| | - John S Luque
- Institute of Public Health, College of Pharmacy and Pharmaceutical Sciences, 15467Florida A&M University, FL, USA
| |
Collapse
|
5
|
Subjective cognitive decline and elder mistreatment in Mexican community-dwelling older adults. Arch Gerontol Geriatr 2020; 92:104242. [PMID: 33010789 DOI: 10.1016/j.archger.2020.104242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 07/28/2020] [Accepted: 08/21/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVES Elder mistreatment in individuals with subjective cognitive decline is an understudied public health problem that violates human rights. DESIGN AND METHODS Cross-sectional study of 386 Mexican community-dwelling older adults. Individuals with episodic memory, executive function, language, visuospatial skills or attention cognitive complaints without low cognitive performance scores in the Mini-Mental State Examination and the Isaacs Set Test that were considered positive for subjective cognitive decline (SCD). Elder mistreatment (EM) was considered positive if any of the questions on the Geriatric Mistreatment Scale were answered affirmatively. Logistic regression models were created to test the association between SCD and EM. RESULTS After adjustments made by age, sex, education and depressive symptoms a positive association was found between SCD and EM (OR = 2.226; 95%CI = 1.296 to 3.822 ; p = 0.004). This association was observed in all subtypes of cognitive complaints except excecutive function: episodic memory (OR = 2.219 ; 95%CI = 1.321 to 3.728 ; p = 0.003), language (OR = 2.500 ; 95% CI = 1.422 to 4.396 ; p = 0.001), visuospatial (OR = 2.158 ; 95%CI = 1.162 to 4.007 ; p = 0.015), attention (OR = 2.197 ; 95%CI = 1.206 to 4.001 ; p = 0.010) and executive (OR = 1 2.062 ; 95%CI = 0.981 to 4.333 ; p = 0.056). Discussion and Implications: This study brings to light the relation between SCD and EM in a population where it has been understudied. Exploring mistreatment in older adults who experience subjective cognitive decline might help preserve their safety and create future prevention and intervention strategies.
Collapse
|
6
|
Curcio CL, Payán-Villamizar C, Jiménez A, Gómez F. Abuse in Colombian elderly and its association with socioeconomic conditions and functionality. Colomb Med (Cali) 2019; 50:77-88. [PMID: 31607765 PMCID: PMC6774576 DOI: 10.25100/cm.v50i2.4013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: To describe the presence of abuse in elderly people in Colombia and its association with socio-demographic and functional conditions. Methods: Cross-sectional and descriptive research. Data were taken from the SABE Colombia Survey, a population study, with a national representative sample of 23,694 adults aged over 60 years. Presence and type of abuse by partners or family members, members were investigated. Generalized linear models with Poisson link function were used to estimate the causes of the prevalence of abuse by area of residence, region, age, sex, dependence on activities of daily living and living arrangements. Results: 15.1% of the elderly in Colombia reported some type of abuse, and over 50% reported more than one form of abuse. Abuse proportion is greater in people who are aged 60-69, in women, people with lower levels of education, people who belong to lower socioeconomic status, people who live alone, people who live with children, and people in urban areas. The most frequent abuse form is psychological, followed by neglect and physical abuse. Dependence on basic and instrumental daily living activities increases the probabilities of suffering abuse. Conclusions: Home is a risky place for the elderly people, especially for those with functional dependence, those who belong to low socioeconomic strata and women. Results should encourage debate among researchers, professionals and decision makers on public policy about necessary actions and means to change violent family dynamics in homes with elderly people.
Collapse
Affiliation(s)
- Carmen-Lucia Curcio
- Universidad de Caldas, Grupo de Investigaciones en Gerontología y Geriatría, Manizales, Colombia
| | | | - Abelardo Jiménez
- Fundación Universitaria San Martín, Medicina, Public Health Research Group GISAP, Cali, Colombia.,Universidad del Valle, Escuela de Salud Pública, Cali, Colombia
| | - Fernando Gómez
- Universidad de Caldas, Grupo de Investigaciones en Gerontología y Geriatría, Manizales, Colombia
| |
Collapse
|