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Herrera-Perez E, Custodio N, Diaz M, Montesinos R, Chang A, Villafuerte M, Lanata S. Epidemiology of neurocognitive disorders in adults from urban-marginalized areas: a door-to-door population-based study in Puente Piedra, Lima, Peru. Front Public Health 2023; 11:1228008. [PMID: 37927880 PMCID: PMC10622761 DOI: 10.3389/fpubh.2023.1228008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/02/2023] [Indexed: 11/07/2023] Open
Abstract
Background In Latin America (LA), the prevalence of dementia is expected to triple to 150 million people by 2050. The 2020 Lancet Commission report identified several modifiable dementia risk factors, yet few social and environmental factors, most relevant to vulnerable regions of LA, were highlighted in this report. We sought to assess the epidemiology of neurocognitive disorders (NCD) in Puente Piedra, one of the most socially and economically vulnerable districts of Lima, the capital of Peru. Methodology This was a cross-sectional door-to-door observational study that used two-stage household sampling. One young adult (30-59 years) and one older adult (>60 years) per household were enrolled. We collected demographic, clinical, and neurocognitive data. Addenbrooke's Cognitive Examination (young adults) and the RUDAS-PE (older adults) were used, classifying participants as cognitively normal, possible mild NCD, or possible major NCD. Results We enrolled 247 participants (median age 46 years; 67% female). One-fourth had not completed secondary school and more than 50% completed only secondary school. Most participants were housewives (46%) and 21% did not have health insurance. The overall prevalence of possible NCD was 30% (25.6 and 41.8% among younger adults and older adults, respectively). Among younger adults, those ages 55-59 years more frequently had NCD (70%) compared to younger age ranges. Among older adults, only 3 subjects (4.5%) had major NCD. Conclusion We found a high frequency of possible NCDs in a socially and economically vulnerable community in Lima, Peru, with younger adults showing levels of NCD higher than expected. Our findings support the need for health systems to incorporate cognitive screenings programs for NCD in younger ages. Future research on NCD would include younger populations, particularly in vulnerable communities.
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Affiliation(s)
- Eder Herrera-Perez
- Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Centro de Excelencia en Biotecnología e Investigación Traslacional, Lima, Peru
| | - Nilton Custodio
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
| | - Monica Diaz
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Rosa Montesinos
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
| | - Alexandra Chang
- Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | | | - Serggio Lanata
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
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Parra MA, Orellana P, Leon T, Victoria CG, Henriquez F, Gomez R, Avalos C, Damian A, Slachevsky A, Ibañez A, Zetterberg H, Tijms BM, Yokoyama JS, Piña-Escudero SD, Cochran JN, Matallana DL, Acosta D, Allegri R, Arias-Suárez BP, Barra B, Behrens MI, Brucki SMD, Busatto G, Caramelli P, Castro-Suarez S, Contreras V, Custodio N, Dansilio S, De la Cruz-Puebla M, de Souza LC, Diaz MM, Duque L, Farías GA, Ferreira ST, Guimet NM, Kmaid A, Lira D, Lopera F, Meza BM, Miotto EC, Nitrini R, Nuñez A, O'neill S, Ochoa J, Pintado-Caipa M, de Paula França Resende E, Risacher S, Rojas LA, Sabaj V, Schilling L, Sellek AF, Sosa A, Takada LT, Teixeira AL, Unaucho-Pilalumbo M, Duran-Aniotz C. Biomarkers for dementia in Latin American countries: Gaps and opportunities. Alzheimers Dement 2023; 19:721-735. [PMID: 36098676 PMCID: PMC10906502 DOI: 10.1002/alz.12757] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 05/29/2022] [Accepted: 06/14/2022] [Indexed: 12/13/2022]
Abstract
Limited knowledge on dementia biomarkers in Latin American and Caribbean (LAC) countries remains a serious barrier. Here, we reported a survey to explore the ongoing work, needs, interests, potential barriers, and opportunities for future studies related to biomarkers. The results show that neuroimaging is the most used biomarker (73%), followed by genetic studies (40%), peripheral fluids biomarkers (31%), and cerebrospinal fluid biomarkers (29%). Regarding barriers in LAC, lack of funding appears to undermine the implementation of biomarkers in clinical or research settings, followed by insufficient infrastructure and training. The survey revealed that despite the above barriers, the region holds a great potential to advance dementia biomarkers research. Considering the unique contributions that LAC could make to this growing field, we highlight the urgent need to expand biomarker research. These insights allowed us to propose an action plan that addresses the recommendations for a biomarker framework recently proposed by regional experts.
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Affiliation(s)
- Mario A. Parra
- School of Psychological Sciences and Health, University of Strathclyde. Glasgow, United Kingdom
| | - Paulina Orellana
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez. Santiago, Chile
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez. Santiago, Chile
| | - Tomas Leon
- Global Brain Health Institute, Trinity College. Dublin, Ireland
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador y Facultad de Medicina, Universidad de Chile. Santiago, Chile
| | - Cabello G. Victoria
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez. Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department - Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, Universidad de Chile. Santiago, Chile
- Unit of Brain Health, Department of Neurology and Neurosurgery, Faculty of Medicine, Universidad de Chile. Santiago, Chile
| | - Fernando Henriquez
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department - Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, Universidad de Chile. Santiago, Chile
- Geroscience Center for Brain Health and Metabolism (GERO). Santiago, Chile
- Laboratory for Cognitive and Evolutionary Neuroscience (LaNCE), Department of Psychiatry, Faculty of Medicine, Pontificia Universidad Católica de Chile. Santiago, Chile
| | - Rodrigo Gomez
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador y Facultad de Medicina, Universidad de Chile. Santiago, Chile
- Graduate School, Faculty of Medicine, Universidad Mayor, Chile - Centro de Apoyo Comunitario a personas con Demencia Kintun. Santiago, Chile
| | - Constanza Avalos
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez. Santiago, Chile
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez. Santiago, Chile
| | - Andres Damian
- Centro Uruguayo de Imagenología Molecular (CUDIM) - Centro de Medicina Nuclear e Imagenología Molecular, Hospital de Clínicas, Universidad de la República. Montevideo, Uruguay
| | - Andrea Slachevsky
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador y Facultad de Medicina, Universidad de Chile. Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department - Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, Universidad de Chile. Santiago, Chile
- Geroscience Center for Brain Health and Metabolism (GERO). Santiago, Chile
- Department of Neurology and Psyquiatry, Clínica Alemana-Universidad del Desarrollo. Santiago, Chile
| | - Agustin Ibañez
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez. Santiago, Chile
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez. Santiago, Chile
- Global Brain Health Institute, Trinity College. Dublin, Ireland
- Global Brain Health Institute and the Memory and Aging Center, Weill Institute for Neurosciences, Departments of Neurology and Radiology & Biomedical Imaging, University of California, San Francisco (UCSF). San Francisco, USA
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, & National Scientific and Technical Research Council (CONICET). Buenos Aires, Argentina
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg. Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital. Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology. Queen Square, London, UK
- UK Dementia Research Institute at UCL. London, UK
- Hong Kong Center for Neurodegenerative Diseases. Clear Water Bay, Hong Kong, China
| | - Betty M. Tijms
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience. Amsterdam UMC, The Netherlands
| | - Jennifer S. Yokoyama
- Global Brain Health Institute and the Memory and Aging Center, Weill Institute for Neurosciences, Departments of Neurology and Radiology & Biomedical Imaging, University of California, San Francisco (UCSF). San Francisco, USA
- Department of Neurology, Memory and Aging Center, UCSF. San Francisco, USA
| | - Stefanie D. Piña-Escudero
- Atlantic Fellow for Equity in Brain Health at the Global Brain Health Institute (GBHI), University of California San Francisco. San Francisco, USA
| | | | - Diana L Matallana
- Medical School, Aging Institute and Psychiatry Department, Neuroscience PhD Program, Pontificia Universidad Javeriana. Bogotá,Colombia
- Memory and Cognition Center, Intellectus, Hospital Universitario San Ignacio. Bogotá, Colombia
- Psychiatry Department, Hospital Universitario Santa Fe de Bogotá. Bogotá, Colombia
| | - Daisy Acosta
- Universidad Nacional Pedro Henriquez Urena (UNPHU). Santo Domingo, República Dominicana
| | - Ricardo Allegri
- Department of Cognitive Neurology, Neuropsychiatry and Neuropsychology, Instituto Neurológico Fleni. Buenos Aires, Argentina
- Department of Neurosciences, Universidad de la Costa. Barranquilla, Colombia
| | - Bianca P. Arias-Suárez
- Faculty of Human Medicine, Postgraduate Section, National University of San Marcos. Lima, Perú
| | - Bernardo Barra
- Mental Health Service, Clínica Universidad de los Andes. Santiago, Chile
- Department of Psychiatry, Medicine School, Andrés Bello University of Santiago (UNAB). Santiago, Chile
| | - Maria Isabel Behrens
- Department of Neurology and Psyquiatry, Clínica Alemana-Universidad del Desarrollo. Santiago, Chile
- Center for Advanced Clinical Research (CICA). Department of Neurology & Neurosurgery and Neuroscience Department, Faculty of Medicine, Universidad de Chile. Santiago, Chile
- Department of Neurology and Neurosurgery, Hospital Clínico Universidad de Chile. Santiago, Chile
- Department of Neurocience, Faculty of Medicine, Universidad de Chile. Santiago, Chile
| | - Sonia M. D. Brucki
- Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo Medical School, University of São Paulo. São Paulo, Brazil
| | - Geraldo Busatto
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP. São Paulo, Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais. Belo Horizonte, Brazil
| | - Sheila Castro-Suarez
- Atlantic Fellow for Equity in Brain Health at the Global Brain Health Institute (GBHI), University of California San Francisco. San Francisco, USA
- Instituto Nacional de Ciencias Neurológicas. Lima, Perú
| | | | - Nilton Custodio
- Unit of diagnosis of cognitive impairment and dementia prevention, Instituto Peruano de Neurociencias.Lima, Perú
| | - Sergio Dansilio
- Department of Neuropsychology, Institut of Neurology, Hospital de Clínicas, Faculty of Medicine,Universidad de la República. Montevideo, Uruguay
| | - Myriam De la Cruz-Puebla
- Global Brain Health Institute and the Memory and Aging Center, Weill Institute for Neurosciences, Departments of Neurology and Radiology & Biomedical Imaging, University of California, San Francisco (UCSF). San Francisco, USA
- Cognition and Brain Plasticity Unit, Bellvitge Biomedical Research Institute. Barcelona, Spain
- Department of Cellular Biology, Physiology and Immunology, Neuroscience Institute, Autonomous University of Barcelona. Barcelona, Spain
- Department of Internal Medicine, Health Sciences Faculty, Technical University of Ambato. Tungurahua, Ecuador
| | - Leonardo Cruz de Souza
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP. São Paulo, Brazil
- Neurology Service, School of Medicine, Pontifical University of Rio Grande do Sul (PUCRS). Porto Alegre, Brazil
| | - Monica M. Diaz
- Department of Neurology, University of North Carolina at Chapel Hill. North Carolina, USA
- School of Public Health, Universidad Peruana Cayetano Heredia. Lima, Peru
| | - Lissette Duque
- Unit of Cognitive diseases, Neuromedicenter. Quito, Ecuador
| | - Gonzalo A. Farías
- Center for Advanced Clinical Research (CICA). Department of Neurology & Neurosurgery and Neuroscience Department, Faculty of Medicine, Universidad de Chile. Santiago, Chile
| | - Sergio T. Ferreira
- Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro. Rio de Janeiro, Brazil
| | - Nahuel Magrath Guimet
- Atlantic Fellow for Equity in Brain Health at the Global Brain Health Institute (GBHI), University of California San Francisco. San Francisco, USA
- Department of Cognitive Neurology, Neuropsychiatry and Neuropsychology, Instituto Neurológico Fleni. Buenos Aires, Argentina
| | - Ana Kmaid
- Unit of Cognitive evaluation. Department of Geriatry ang Gerentology. Hospital de Clínicas. Faculty of Medicine. Universidad de la República. Montevideo, Uruguay
| | - David Lira
- Unit of diagnosis of cognitive impairment and dementia prevention, Instituto Peruano de Neurociencias.Lima, Perú
| | - Francisco Lopera
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, School of Medicine. Medellín, Colombia
| | - Beatriz Mar Meza
- Atlantic Fellow for Equity in Brain Health at the Global Brain Health Institute (GBHI), University of California San Francisco. San Francisco, USA
- Department of Geriatry ang Gerentology, Hospital Central de la Fuerza Aérea del Perú. Lima, Perú
| | - Eliane C Miotto
- Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo Medical School, University of São Paulo. São Paulo, Brazil
| | - Ricardo Nitrini
- Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo Medical School, University of São Paulo. São Paulo, Brazil
| | - Alberto Nuñez
- Unit of Cognitive diseases, Neuromedicenter. Quito, Ecuador
| | - Santiago O'neill
- Neurosciences Institute, Favaloro Foundation University Hospital. Buenos Aires, Argentina
| | - John Ochoa
- Group of Neuropsychology and behavior, Universidad de Antioquia, School of Medicine. Medellín, Colombia
| | - Maritza Pintado-Caipa
- Atlantic Fellow for Equity in Brain Health at the Global Brain Health Institute (GBHI), University of California San Francisco. San Francisco, USA
- Unit of diagnosis of cognitive impairment and dementia prevention, Instituto Peruano de Neurociencias.Lima, Perú
| | - Elisa de Paula França Resende
- Global Brain Health Institute and the Memory and Aging Center, Weill Institute for Neurosciences, Departments of Neurology and Radiology & Biomedical Imaging, University of California, San Francisco (UCSF). San Francisco, USA
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais. Belo Horizonte, Brazil
- Neurology Service, School of Medicine, Pontifical University of Rio Grande do Sul (PUCRS). Porto Alegre, Brazil
- Brain Institute of Rio Grande do Sul, Pontifical University of Rio Grande do Sul (PUCRS). Porto Alegre, Brazil
- Faculdade de Ciências Médicas de Minas Gerais. Belo Horizonte, Brazil
| | - Shannon Risacher
- Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana Alzheimer’s Disease Research Center, Department of Neurology, Indiana University School of Medicine. Indianapolis, USA
| | - Luz Angela Rojas
- Research Group, MI Dneuropsy, Universidad Surcolombiana. Neiva, Colombia
| | - Valentina Sabaj
- Unit of Neuropsychogeriatry, Instituto Nacional de Geriatría. Santiago, Chile
| | - Lucas Schilling
- Neurology Service, School of Medicine, Pontifical University of Rio Grande do Sul (PUCRS). Porto Alegre, Brazil
- Brain Institute of Rio Grande do Sul, Pontifical University of Rio Grande do Sul (PUCRS). Porto Alegre, Brazil
- Graduate Program in Biomedical Gerontology, Pontifical University of Rio Grande do Sul (PUCRS). Porto Alegre, Brazil
| | | | - Ana Sosa
- Instituto Nacional de Neurología y Neurocirugía (INNN), Manuel Velasco Suarez. Ciudad de México, México
| | - Leonel T. Takada
- Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo Medical School, University of São Paulo. São Paulo, Brazil
| | - Antonio L. Teixeira
- Faculdade Santa Casa BH. Belo Horizonte, Brazil
- Neuropsychiatry Program, University of Texas Health Science Center at Houston. Houston, USA
| | - Martha Unaucho-Pilalumbo
- Atlantic Fellow for Equity in Brain Health at the Global Brain Health Institute (GBHI), University of California San Francisco. San Francisco, USA
- Departamento de Neurología, Hospital Universidad Técnica Particular de Loja. Loja, Ecuador
| | - Claudia Duran-Aniotz
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez. Santiago, Chile
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez. Santiago, Chile
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Exploring the Association between Vitamin D and Changes in Cognitive Function in Chilean Older Adults: Evidence from the ALEXANDROS Cohort Study. J Pers Med 2022; 12:jpm12071078. [PMID: 35887574 PMCID: PMC9319397 DOI: 10.3390/jpm12071078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/23/2022] [Accepted: 06/28/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The increasing aging of the population with the consequent increase of age-associated cognitive disorders pose the challenge of controlling its preventable risk factors, among which vitamin D deficit is a putative factor. Thus, our objective is to explore the association between vitamin D and cognitive performance in a cohort study of community-dwelling Chilean older people. Material and Methods: Cohort study of 955 (69.7% female), community-dwelling older Chileans free of cognitive impairment from the Alexandros cohorts, with 25(OH)D measurement at baseline. Cognitive Function was evaluated with the Mini Mental State Examination (MMSE) short-form questionnaire. Plasma levels of 25(OH)D were classified as Normal > 30 ng/mL Insufficiency 20−29 ng/mL, Deficiency 20−12 ng/mL and Severe Deficiency < 12 ng/mL. Penalized regressions models were made to assess associations. Results: Mean age of the sample was 66.6 + 4.5 years, with 8.5 + 4.7 years of education. After a mean follow-up of 9.6 years, 54 new cases of Mild Cognitive Impairment (MCI)were identified (Incidence density rate = 5.9 per 1000 person/years). Mean vitamin D plasma levels were lower in people with MCI than in the normal cognitive ones (23.0 + 12.75 vs. 28.35 + 15.17 ng/mL, p < 0.01). In the fully adjusted model only severe deficiency of vitamin D was associated with MCI (RR = 2.33; 95% CI: (1.03−5.26). Conclusions: In this longitudinal study, our results confirm that low Vitamin D is a risk factor for MCI, and that people with severe deficiency have more than double the risk of MCI people with normal Vitamin D levels. Considering the high frequency of vitamin D deficiency in older people, and its preventability, these results are very valuable for future public health programmes.
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Dementia caregiving across Latin America and the Caribbean and brain health diplomacy. LANCET HEALTHY LONGEVITY 2021; 2:e222-e231. [PMID: 34790905 PMCID: PMC8594860 DOI: 10.1016/s2666-7568(21)00031-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The prevalence of dementia in Latin America and the Caribbean is growing rapidly, increasing the burden placed on caregivers. Exacerbated by fragile health-care systems, unstable economies, and extensive inequalities, caregiver burden in this region is among the highest in the world. We reviewed the major challenges to caregiving in Latin America and the Caribbean, and we propose regional and coordinated actions to drive future change. Current challenges include the scarcity of formal long-term care, socioeconomic and social determinants of health disparities, gender-biased burdens, growing dementia prevalence, and the effect of the current COVID-19 pandemic on families affected by dementia. Firstly, we propose local and regional short-term strategic recommendations, including systematic identification of specific caregiver needs, testing of evidence-based local interventions, contextual adaptation of strategies to different settings and cultures, countering gender bias, strengthening community support, provision of basic technology, and better use of available information and communications technology. Additionally, we propose brain health diplomacy (ie, global actions aimed to overcome the systemic challenges to brain health by bridging disciplines and sectors) and convergence science as frameworks for long-term coordinated responses, integrating tools, knowledge, and strategies to expand access to digital technology and develop collaborative models of care. Addressing the vast inequalities in dementia caregiving across Latin America and the Caribbean requires innovative, evidence-based solutions coordinated with the strengthening of public policies.
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Diaz MM, Custodio N, Montesinos R, Lira D, Herrera-Perez E, Pintado-Caipa M, Cuenca-Alfaro J, Gamboa C, Lanata S. Thyroid Dysfunction, Vitamin B12, and Folic Acid Deficiencies Are Not Associated With Cognitive Impairment in Older Adults in Lima, Peru. Front Public Health 2021; 9:676518. [PMID: 34552900 PMCID: PMC8450418 DOI: 10.3389/fpubh.2021.676518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 08/12/2021] [Indexed: 01/27/2023] Open
Abstract
Background: Reversible etiologies of cognitive impairment are common and treatable, yet the majority of mild cognitive impairment (MCI) and dementia research in Latin America has focused on irreversible, neurodegenerative etiologies. Objective: We sought to determine if thyroid dysfunction and vitamin B12 and folate deficiencies are associated with cognitive disorders among older adults with memory complaints in Lima, Peru. Methods: This was a retrospective review of patients who presented for cognitive evaluations to a multidisciplinary neurology clinic in Lima, Peru from January 2014 to February 2020. We included individuals aged ≥60 years, native Spanish-speakers, with at least a primary school educational level and a complete clinical assessment. Patients had either subjective cognitive decline (SCD), MCI, or dementia. One-way ANOVA and multiple logistic regression analyses were performed. Results: We included 720 patients (330 SCD, 154 MCI, and 236 dementia); the dementia group was significantly older [mean age SCD 69.7 ± 4.1, dementia 72.4 ± 3.7 (p = 0.000)] and had lower folate levels than SCD patients. The MCI group had higher free T3 levels compared with SCD patients. Those with lower TSH had greater dementia risk (OR = 2.91, 95%CI: 1.15-6.86) but not MCI risk in unadjusted models. B12 deficiency or borderline B12 deficiency was present in 34% of the dementia group, yet no clear correlation was seen between neuropsychological test results and B12 levels in our study. There was no association between MCI or dementia and thyroid hormone, B12 nor folate levels in adjusted models. Conclusion: Our findings do not support an association between metabolic and endocrine disorders and cognitive impairment in older Peruvians from Lima despite a high prevalence of B12 deficiency. Future work may determine if cognitive decline is associated with metabolic or endocrine changes in Latin America.
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Affiliation(s)
- Monica M. Diaz
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Nilton Custodio
- Servicio de Neurología, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
| | - Rosa Montesinos
- Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Servicio de Rehabilitación, Instituto Peruano de Neurociencias, Lima, Peru
| | - David Lira
- Servicio de Neurología, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
| | - Eder Herrera-Perez
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Grupo de investigación Molident, Universidad San Ignacio de Loyola, Lima, Peru
| | - Maritza Pintado-Caipa
- Servicio de Neurología, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Atlantic Fellow, Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
| | - Jose Cuenca-Alfaro
- Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Servicio de Neuropsicología, Instituto Peruano de Neurociencias, Lima, Peru
- Carrera de Psicología, Facultad de Ciencias de la Salud, Universidad Privada del Norte, Lima, Peru
| | - Carlos Gamboa
- Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Servicio de Neuropsicología, Instituto Peruano de Neurociencias, Lima, Peru
| | - Serggio Lanata
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
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Soto-Añari M, Camargo L, Ramos-Henderson M, Rivera-Fernández C, Denegri-Solís L, Calle U, Mori N, Ocampo-Barbá N, López F, Porto M, Caldichoury-Obando N, Saldías C, Gargiulo P, Castellanos C, Shelach-Bellido S, López N. Prevalence of Dementia and Associated Factors among Older Adults in Latin America during the COVID-19 Pandemic. Dement Geriatr Cogn Dis Extra 2021; 11:213-221. [PMID: 34721498 PMCID: PMC8543347 DOI: 10.1159/000518922] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 07/17/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has had a great impact on cognitive health in Latin American older adults, increasing the risk of cognitive impairment and dementia. Our objective was to analyze the prevalence of dementia and the associated factors in Latin American older adults during SARS-CoV-2 pandemic. METHODS A multicentric first phase cross-sectional observational study was conducted during the SARS-CoV-2 pandemic. Five thousand two hundred and forty-five Latin American adults over 60 years of age were studied in 10 countries: Argentina, Bolivia, Chile, Colombia, Ecuador, Guatemala, Mexico, Peru, the Dominican Republic, and Venezuela. We used the telephone version of Montreal Cognitive Assessment, the "Alzheimer Disease 8" scale for functional and cognitive changes, and the abbreviated version of the Yesavage depression scale. We also asked for sociodemographic and lockdown data. All the evaluation was made by telephone. Cross-tabulations and χ2 tests were used to determine the variability of the prevalence of impairment by sociodemographic characteristics and binary logistic regression to assess the association between dementia and sociodemographic factors. RESULTS We observed that the prevalence of dementia in Latin America is 15.6%, varying depending on the country (Argentine = 7.83 and Bolivia = 28.5%). The variables most associated with dementia were race and age. It does not seem to be associated with the pandemic but with social and socio-health factors. CONCLUSION The prevalence of dementia shows a significant increase in Latin America, attributable to a constellation of ethnic, demographic, and socioeconomic factors.
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Affiliation(s)
- Marcio Soto-Añari
- Laboratorio de Neurociencia, Departamento de Psicología, Universidad Católica San Pablo, Arequipa, Peru
| | - Loida Camargo
- Escuela de Medicina, Universidad del Sinú, Cartagena de Indias, Colombia
- Fundación Centro Colombiano de Epilepsia y Enfermedades Neurológicas Jaime Fandiño Franky (FIRE), Cartagena de Indias, Colombia
| | - Miguel Ramos-Henderson
- Centro de Investigación e Innovación en Gerontología Aplicada (CIGAP), Facultad de Salud, Universidad Santo Tomás, Santiago, Chile
| | | | | | | | | | - Ninoska Ocampo-Barbá
- Instituto de Neurociencias Comportamentales (INCC), Universidad Autónoma Gabriel René Moreno (UAGRM), Santa Cruz de la Sierra, Bolivia
| | - Fernanda López
- Hospital Nacional Dr. Alejandro Posadas, Buenos Aires, Argentina
| | - Maria Porto
- Universidad de La Costa, Barranquilla, Colombia
| | | | - Carol Saldías
- Facultad de Ciencias de la Salud, Universidad San Sebastián, Valdivia, Chile
| | - Pascual Gargiulo
- Laboratorio de Neurociencias y Psicología Experimental, CONICET, Facultad de Ciencias Médicas, Universidad Nacional de Cuyo, Mendoza, Argentina
| | - Cesar Castellanos
- Instituto Dominicano para el estudio de la Salud Integral y la Psicología Aplicada (IDESIP), Santo Domingo, Dominican Republic
| | - Salomon Shelach-Bellido
- Laboratorio de Neurociencia, Departamento de Psicología, Universidad Católica San Pablo, Arequipa, Peru
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7
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Ibanez A, Parra MA, Butler C. The Latin America and the Caribbean Consortium on Dementia (LAC-CD): From Networking to Research to Implementation Science. J Alzheimers Dis 2021; 82:S379-S394. [PMID: 33492297 PMCID: PMC8293660 DOI: 10.3233/jad-201384] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In comparison with other regions, dementia prevalence in Latin America is growing rapidly, along with the consequent clinical, social, and economic burden upon patients and their families. The combination of fragile health care systems, large social inequalities, and isolated clinical and research initiatives makes the coordination of efforts imperative. The Latin America and the Caribbean Consortium on Dementia (LAC-CD) is a regional organization overseeing and promoting clinical and research activities on dementia. Here, we first provide an overview of the consortium, highlighting the antecedents and current mission. Then, we present the consortium’s regional research, including the multi-partner consortium to expand dementia research in Latin America (ReDLat), which aims to identify the unique genetic, social, and economic factors that drive Alzheimer’s and frontotemporal dementia presentation in LAC relative to the US. We describe an extension of ReDLat which aims to develop affordable markers of disease subtype and severity using high density EEG. We introduce current initiatives promoting regional diagnosis, visibility, and capacity, including the forthcoming launch of the Latin American Brain Health Institute (BrainLat). We discuss LAC-CD-led advances in brain health diplomacy, including an assessment of responses to the impact of COVID-19 on people with dementia and examining the knowledge of public policies among experts in the region. Finally, we present the current knowledge-to-action framework, which paves the way for a future regional action plan. Coordinated actions are crucial to forging strong regional bonds, supporting the implementation of regional dementia plans, improving health systems, and expanding research collaborations across Latin America.
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Affiliation(s)
- Agustin Ibanez
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, CA, USA.,Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.,Universidad Autónoma del Caribe, Barranquilla, Barranquilla, Colombia.,Latin American Institute for Brain Health (BrainLat), Center for Social and Cognitive Neuroscience (CSCN), Universidad Adolfo Ibanez, Santiago de Chile, Chile
| | - Mario A Parra
- Universidad Autónoma del Caribe, Barranquilla, Barranquilla, Colombia.,School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Christopher Butler
- Department of Brain Sciences, Imperial College London, UK.,Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.,Instituto de Neurología Cognitiva, Buenos Aires, Argentina.,Departamento de Neurología, Pontificia Universidad de Chile, Santiago, Chile
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8
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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.
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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
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9
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Custodio N, Montesinos R, Diaz MM, Herrera-Perez E, Chavez K, Alva-Diaz C, Reynoso-Guzman W, Pintado-Caipa M, Cuenca J, Gamboa C, Lanata S. Performance of the Rowland Universal Dementia Assessment Scale for the Detection of Mild Cognitive Impairment and Dementia in a Diverse Cohort of Illiterate Persons From Rural Communities in Peru. Front Neurol 2021; 12:629325. [PMID: 34305773 PMCID: PMC8292605 DOI: 10.3389/fneur.2021.629325] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 06/14/2021] [Indexed: 12/05/2022] Open
Abstract
Background: The accurate diagnosis of neurocognitive disorders in illiterate Peruvian populations is challenging, largely owing to scarcity of brief cognitive screening tools (BCST) validated in these diverse populations. The Peruvian version of the Rowland Universal Dementia Assessment Scale (RUDAS-PE) is a BCST that relies minimally on educational attainment and has shown good diagnostic accuracy in an urban illiterate population in Peru, yet its psychometric properties in illiterate populations in rural settings of the country have not been previously investigated. Objectives: To establish the diagnostic accuracy of the RUDAS-PE compared to expert clinical diagnosis using the Clinical Dementia Rating (CDR) Scale in healthy and cognitively impaired illiterate persons living in two culturally and geographically distinct rural communities of Peru. Methods: A cross-sectional, population-based study of residents ≥ 50 years of age living in the Peruvian rural communities of Santa Clotilde and Chuquibambilla. A total of 129 subjects (76 from Santa Clotilde and 53 from Chuquibambilla) were included in this study. Gold standard diagnostic neurocognitive evaluation was based on expert neurological history and examination and administration of the CDR. Receiver operating characteristics, areas under the curve (AUC), and logistic regression analyses were conducted to determine the performance of RUDAS-PE compared to expert gold standard diagnosis. Results: Compared to gold standard diagnosis, the RUDAS-PE was better at correctly discriminating between MCI and dementia than discriminating between MCI and controls in both sites (97.0% vs. 76.2% correct classification in Chuquibambilla; 90.0% vs. 64.7% in Santa Clotilde). In Chuquibambilla, the area under the curve (AUC) of the RUDAS to discriminate between dementia and MCI was 99.4% (optimal cutoff at <18), whereas between MCI and controls it was 82.8% (optimal cutoff at <22). In Santa Clotilde, the area under the curve (AUC) of the RUDAS to discriminate between dementia and MCI was 99.1% (optimal cutoff at <17), whereas between MCI and controls it was 75.5% (optimal cutoff at <21). Conclusions: The RUDAS-PE has acceptable psychometric properties and performed well in its ability to discriminate MCI and dementia in two cohorts of illiterate older adults from two distinct rural Peruvian communities.
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Affiliation(s)
- Nilton Custodio
- Servicio de Neurología, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
| | - Rosa Montesinos
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Servicio de Rehabilitación, Instituto Peruano de Neurociencias, Lima, Peru
| | - Monica M. Diaz
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Unidad de epidemiología, ITS y VIH, Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Eder Herrera-Perez
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Grupo de investigación Molident, Universidad San Ignacio de Loyola, Lima, Peru
| | - Kristhy Chavez
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
| | - Carlos Alva-Diaz
- Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Peru
| | - Willyams Reynoso-Guzman
- Servicio de Neurología, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
| | - Maritza Pintado-Caipa
- Servicio de Neurología, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Atlantic Fellow, Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
| | - José Cuenca
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Servicio de Rehabilitación, Instituto Peruano de Neurociencias, Lima, Peru
- Servicio de Neuropsicología, Instituto Peruano de Neurociencias, Lima, Peru
- Carrera de Psicología, Facultad de Ciencias de la Salud, Universidad Privada del Norte, Lima, Peru
| | - Carlos Gamboa
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Servicio de Neuropsicología, Instituto Peruano de Neurociencias, Lima, Peru
| | - Serggio Lanata
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
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10
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Duran-Aniotz C, Orellana P, Leon Rodriguez T, Henriquez F, Cabello V, Aguirre-Pinto MF, Escobedo T, Takada LT, Pina-Escudero SD, Lopez O, Yokoyama JS, Ibanez A, Parra MA, Slachevsky A. Systematic Review: Genetic, Neuroimaging, and Fluids Biomarkers for Frontotemporal Dementia Across Latin America Countries. Front Neurol 2021; 12:663407. [PMID: 34248820 PMCID: PMC8263937 DOI: 10.3389/fneur.2021.663407] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/27/2021] [Indexed: 11/13/2022] Open
Abstract
Frontotemporal dementia (FTD) includes a group of clinically, genetically, and pathologically heterogeneous neurodegenerative disorders, affecting the fronto-insular-temporal regions of the brain. Clinically, FTD is characterized by progressive deficits in behavior, executive function, and language and its diagnosis relies mainly on the clinical expertise of the physician/consensus group and the use of neuropsychological tests and/or structural/functional neuroimaging, depending on local availability. The modest correlation between clinical findings and FTD neuropathology makes the diagnosis difficult using clinical criteria and often leads to underdiagnosis or misdiagnosis, primarily due to lack of recognition or awareness of FTD as a disease and symptom overlap with psychiatric disorders. Despite advances in understanding the underlying neuropathology of FTD, accurate and sensitive diagnosis for this disease is still lacking. One of the major challenges is to improve diagnosis in FTD patients as early as possible. In this context, biomarkers have emerged as useful methods to provide and/or complement clinical diagnosis for this complex syndrome, although more evidence is needed to incorporate most of them into clinical practice. However, most biomarker studies have been performed using North American or European populations, with little representation of the Latin American and the Caribbean (LAC) region. In the LAC region, there are additional challenges, particularly the lack of awareness and knowledge about FTD, even in specialists. Also, LAC genetic heritage and cultures are complex, and both likely influence clinical presentations and may modify baseline biomarker levels. Even more, due to diagnostic delay, the clinical presentation might be further complicated by both neurological and psychiatric comorbidity, such as vascular brain damage, substance abuse, mood disorders, among others. This systematic review provides a brief update and an overview of the current knowledge on genetic, neuroimaging, and fluid biomarkers for FTD in LAC countries. Our review highlights the need for extensive research on biomarkers in FTD in LAC to contribute to a more comprehensive understanding of the disease and its associated biomarkers. Dementia research is certainly reduced in the LAC region, highlighting an urgent need for harmonized, innovative, and cross-regional studies with a global perspective across multiple areas of dementia knowledge.
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Affiliation(s)
- Claudia Duran-Aniotz
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Santiago, Chile
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Paulina Orellana
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Santiago, Chile
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Tomas Leon Rodriguez
- Trinity College, Global Brain Health Institute, Dublin, Ireland
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
| | - Fernando Henriquez
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department - Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
| | - Victoria Cabello
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department - Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
| | | | - Tamara Escobedo
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Santiago, Chile
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Leonel T. Takada
- Cognitive and Behavioral Neurology Unit - Department of Neurology, University of São Paulo, São Paulo, Brazil
| | - Stefanie D. Pina-Escudero
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, CA, United States
- UCSF Department of Neurology, Memory and Aging Center, UCSF, San Francisco, CA, United States
| | - Oscar Lopez
- Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jennifer S. Yokoyama
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, CA, United States
- UCSF Department of Neurology, Memory and Aging Center, UCSF, San Francisco, CA, United States
| | - Agustin Ibanez
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Santiago, Chile
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
- Trinity College, Global Brain Health Institute, Dublin, Ireland
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, CA, United States
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, & National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Mario A. Parra
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, United Kingdom
| | - Andrea Slachevsky
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department - Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Cognitive and Behavioral Neurology Unit - Department of Neurology, University of São Paulo, São Paulo, Brazil
- Department of Neurology and Psychiatry, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
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11
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Robert C, Wilson CS, Lipton RB, Arreto CD. Evolution of the Research Literature and the Scientific Community of Alzheimer's Disease from 1983-2017: A 35-Year Survey. J Alzheimers Dis 2021; 75:1105-1134. [PMID: 32390624 DOI: 10.3233/jad-191281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This study surveys the development of Alzheimer's disease (AD) in the research literature, the scientific community, and the journals containing AD papers over a 35-year period. Research papers on AD published from 1983 to 2017 in journals indexed in the Web of Science were analyzed in seven five-year periods. The number of AD papers increased from 1,095 in 1983-1987 to 50,532 by 2013-2017 and in the same time period, the number of participating countries went from 27 to 152. The US was the most prolific country throughout, followed by several European countries, Canada, Australia, and Japan. Asian countries have emerged and by 2013-2017, China surpassed all but the US in productivity. Countries in Latin America and Africa have also contributed to AD research. Additionally, several new non-governmental institutions (e.g., ADNI, ADI) have emerged and now play a key role in the fight against AD. Likewise the AD scientific publishing universe evolved in various aspects: an increase in number of journals containing AD papers (227 journals in 1983-1987 to 3,257 in 2013-2017); appearance of several AD-focused journals, e.g., Alzheimer's & Dementia, Journal of Alzheimer's Disease; and the development of special issues dedicated to AD. Our paper complements the numerous extant papers on theoretical and clinical aspects of AD and provides a description of the research landscape of the countries and journals contributing papers related to AD.
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Affiliation(s)
- Claude Robert
- Université Paris Descartes, Paris, France.,Gliaxone, Saint Germain Sous Doue, France
| | - Concepción S Wilson
- Formerly at: School of Information Systems, Technology and Management, University of New South Wales, UNSW Sydney, Australia
| | - Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Charles-Daniel Arreto
- Gliaxone, Saint Germain Sous Doue, France.,Université Paris Descartes, Faculté de Chirurgie Dentaire, Hôpital Bretonneau, HUPNVS, AP-HP, Paris, France
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12
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Musa G, Slachevsky A, Muñoz-Neira C, Méndez-Orellana C, Villagra R, González-Billault C, Ibáñez A, Hornberger M, Lillo P. Alzheimer's Disease or Behavioral Variant Frontotemporal Dementia? Review of Key Points Toward an Accurate Clinical and Neuropsychological Diagnosis. J Alzheimers Dis 2021; 73:833-848. [PMID: 31884475 DOI: 10.3233/jad-190924] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Alzheimer's disease (AD) and frontotemporal dementia (FTD) are the most common neurodegenerative early-onset dementias. Despite the fact that both conditions have a very distinctive clinical pattern, they present with an overlap in their cognitive and behavioral features that may lead to misdiagnosis or delay in diagnosis. The current review intends to summarize briefly the main differences at the clinical, neuropsychological, and behavioral levels, in an attempt to suggest which aspects would facilitate an adequate diagnosis in a clinical setting, especially in Latin American and low- and middle-income countries, where the resources needed for a differential diagnosis (such as MRI or biomarkers) are not always available. A timely diagnosis of AD and FTD have significant implications for the medical management and quality of life of patients and careers.
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Affiliation(s)
- Gada Musa
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Department of Physiopathology, ICBM, Department of Neurosciences, Department of East Neuroscience, Faculty of Medicine, University of Chile, Providencia, Santiago, Chile.,Universidad de los Andes, Santiago, Chile.,Capredena, Health and Rehabilitation Center, Santiago, Chile
| | - Andrea Slachevsky
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Department of Physiopathology, ICBM, Department of Neurosciences, Department of East Neuroscience, Faculty of Medicine, University of Chile, Providencia, Santiago, Chile.,Gerosciences Center for Brain Health and Metabolism (GERO), Providencia, Santiago, Chile.,Memory and Neuropsychiatric Clinic (CMYN) Neurology Department- Hospital del Salvador and University of Chile, Providencia, Santiago, Chile.,Departamento de Medicina, Servicio de Neurología, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Carlos Muñoz-Neira
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department- Hospital del Salvador and University of Chile, Providencia, Santiago, Chile.,Research into Memory, Brain Sciences and Dementia Group (ReMemBr Group), Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - Carolina Méndez-Orellana
- Carrera de Fonoaudiología, Departamento Ciencias de la Salud, Facultad de Medicina, Universidad Católica de Chile, Santiago, Chile
| | - Roque Villagra
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Department of Physiopathology, ICBM, Department of Neurosciences, Department of East Neuroscience, Faculty of Medicine, University of Chile, Providencia, Santiago, Chile.,Gerosciences Center for Brain Health and Metabolism (GERO), Providencia, Santiago, Chile
| | - Christian González-Billault
- Gerosciences Center for Brain Health and Metabolism (GERO), Providencia, Santiago, Chile.,Department of Biology, Faculty of Sciences, Universidad de Chile, Santiago, Chile.,The Buck Institute for Research on Aging, Novato, CA, USA
| | - Agustín Ibáñez
- Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.,Universidad Autónoma del Caribe, Barranquilla, Colombia.,Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile.,Centre of Excellence in Cognition and its Disorders, Australian Research Council (ACR), Sydney, Australia
| | | | - Patricia Lillo
- Gerosciences Center for Brain Health and Metabolism (GERO), Providencia, Santiago, Chile.,Department of Neurology South, Faculty of Medicine, Universidad de Chile, Santiago, Chile
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13
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Rivera-Fernández C, Custodio N, Soto-Añari M. Neuropsychological profile in the preclinical stages of dementia: principal component analysis approach. Dement Neuropsychol 2021; 15:192-199. [PMID: 34345360 PMCID: PMC8283881 DOI: 10.1590/1980-57642021dn15-020006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/19/2021] [Indexed: 12/27/2022] Open
Abstract
The preclinical stages of dementia include subtle neurocognitive changes that are not easily detected in standard clinical evaluations. Neuropsychological evaluation is important for the classification and prediction of deterioration in all the phases of dementia.
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14
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Ibanez A, Yokoyama JS, Possin KL, Matallana D, Lopera F, Nitrini R, Takada LT, Custodio N, Sosa Ortiz AL, Avila-Funes JA, Behrens MI, Slachevsky A, Myers RM, Cochran JN, Brusco LI, Bruno MA, Brucki SMD, Pina-Escudero SD, Okada de Oliveira M, Donnelly Kehoe P, Garcia AM, Cardona JF, Santamaria-Garcia H, Moguilner S, Duran-Aniotz C, Tagliazucchi E, Maito M, Longoria Ibarrola EM, Pintado-Caipa M, Godoy ME, Bakman V, Javandel S, Kosik KS, Valcour V, Miller BL. The Multi-Partner Consortium to Expand Dementia Research in Latin America (ReDLat): Driving Multicentric Research and Implementation Science. Front Neurol 2021; 12:631722. [PMID: 33776890 PMCID: PMC7992978 DOI: 10.3389/fneur.2021.631722] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 02/15/2021] [Indexed: 12/17/2022] Open
Abstract
Dementia is becoming increasingly prevalent in Latin America, contrasting with stable or declining rates in North America and Europe. This scenario places unprecedented clinical, social, and economic burden upon patients, families, and health systems. The challenges prove particularly pressing for conditions with highly specific diagnostic and management demands, such as frontotemporal dementia. Here we introduce a research and networking initiative designed to tackle these ensuing hurdles, the Multi-partner consortium to expand dementia research in Latin America (ReDLat). First, we present ReDLat's regional research framework, aimed at identifying the unique genetic, social, and economic factors driving the presentation of frontotemporal dementia and Alzheimer's disease in Latin America relative to the US. We describe ongoing ReDLat studies in various fields and ongoing research extensions. Then, we introduce actions coordinated by ReDLat and the Latin America and Caribbean Consortium on Dementia (LAC-CD) to develop culturally appropriate diagnostic tools, regional visibility and capacity building, diplomatic coordination in local priority areas, and a knowledge-to-action framework toward a regional action plan. Together, these research and networking initiatives will help to establish strong cross-national bonds, support the implementation of regional dementia plans, enhance health systems' infrastructure, and increase translational research collaborations across the continent.
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Affiliation(s)
- Agustin Ibanez
- The Global Brain Health Institute (GBHI), University of California, San Francisco, San Francisco, CA, United States
- The Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- School of Psychology, Center for Social and Cognitive Neuroscience, Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Adolfo Ibanez University, Santiago, Chile
| | - Jennifer S. Yokoyama
- The Global Brain Health Institute (GBHI), University of California, San Francisco, San Francisco, CA, United States
- The Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Katherine L. Possin
- The Global Brain Health Institute (GBHI), University of California, San Francisco, San Francisco, CA, United States
- The Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Diana Matallana
- Psychiatry Department, School of Medicine, Aging Institute, Pontificia Universidad Javeriana, Bogotá, Colombia
- Memory and Cognition Clinic, Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia
- Mental Health Unit, Hospital Universitario Santa Fe de Bogotá, Bogotá, Colombia
| | - Francisco Lopera
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - Ricardo Nitrini
- Cognitive and Behavioral Neurology Unit, Hospital das Clinicas, University of São Paulo Medical School, São Paulo, Brazil
| | - Leonel T. Takada
- Cognitive and Behavioral Neurology Unit, Hospital das Clinicas, University of São Paulo Medical School, São Paulo, Brazil
| | - Nilton Custodio
- Unit Cognitive Impairment and Dementia Prevention, Cognitive Neurology Center, Peruvian Institute of Neurosciences, Lima, Perú
| | - Ana Luisa Sosa Ortiz
- Instituto Nacional de Neurologia y Neurocirugia MVS, Universidad Nacional Autonoma de Mexico, Mexico, Mexico
| | - José Alberto Avila-Funes
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico, Mexico
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Bordeaux, France
| | - Maria Isabel Behrens
- Centro de Investigación Clínica Avanzada, Hospital Clínico, Facultad de Medicina Universidad de Chile, Santiago, Chile
- Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Santiago, Chile
- Departamento de Neurociencia, Facultad de Medicina Universidad de Chile, Santiago, Chile
- Clínica Alemana Santiago, Universidad del Desarrollo, Santiago, Chile
| | - Andrea Slachevsky
- Clínica Alemana Santiago, Universidad del Desarrollo, Santiago, Chile
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Department, Institute of Biomedical Sciences, Neuroscience and East Neuroscience, Santiago, Chile
- Faculty of Medicine, University of Chile, Santiago, Chile
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Faculty of Medicine, Hospital del Salvador, University of Chile, Santiago, Chile
| | - Richard M. Myers
- Hudson Alpha Institute for Biotechnology, Huntsville, AL, United States
| | | | - Luis Ignacio Brusco
- Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
- ALZAR – Alzheimer, Buenos Aires, Argentina
| | - Martin A. Bruno
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Facultad Ciencias Médicas, Instituto Ciencias Biomédicas, Universidad Católica de Cuyo, San Juan, Argentina
| | - Sonia M. D. Brucki
- Cognitive and Behavioral Neurology Unit, Hospital das Clinicas, University of São Paulo Medical School, São Paulo, Brazil
- Hospital Santa Marcelina, São Paulo, São Paulo, Brazil
| | - Stefanie Danielle Pina-Escudero
- The Global Brain Health Institute (GBHI), University of California, San Francisco, San Francisco, CA, United States
- The Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Maira Okada de Oliveira
- The Global Brain Health Institute (GBHI), University of California, San Francisco, San Francisco, CA, United States
- The Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
- Cognitive and Behavioral Neurology Unit, Hospital das Clinicas, University of São Paulo Medical School, São Paulo, Brazil
- Hospital Santa Marcelina, São Paulo, São Paulo, Brazil
| | - Patricio Donnelly Kehoe
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Multimedia Signal Processing Group - Neuroimage Division, French-Argentine International Center for Information and Systems Sciences, Rosario, Argentina
| | - Adolfo M. Garcia
- The Global Brain Health Institute (GBHI), University of California, San Francisco, San Francisco, CA, United States
- The Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Faculty of Education, National University of Cuyo, Mendoza, Argentina
| | | | - Hernando Santamaria-Garcia
- Memory and Cognition Clinic, Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia
- Ph.D. Program in Neuroscience, Department of Psychiatry, Physiology, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Sebastian Moguilner
- The Global Brain Health Institute (GBHI), University of California, San Francisco, San Francisco, CA, United States
- The Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
| | - Claudia Duran-Aniotz
- School of Psychology, Center for Social and Cognitive Neuroscience, Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Adolfo Ibanez University, Santiago, Chile
| | - Enzo Tagliazucchi
- Departamento de Física, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Marcelo Maito
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
| | | | - Maritza Pintado-Caipa
- The Global Brain Health Institute (GBHI), University of California, San Francisco, San Francisco, CA, United States
- The Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
- Unit Cognitive Impairment and Dementia Prevention, Cognitive Neurology Center, Peruvian Institute of Neurosciences, Lima, Perú
| | - Maria Eugenia Godoy
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
| | - Vera Bakman
- The Global Brain Health Institute (GBHI), University of California, San Francisco, San Francisco, CA, United States
- The Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
| | - Shireen Javandel
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Kenneth S. Kosik
- Department of Molecular, Cellular, and Developmental Biology, Neuroscience Research Institute, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Victor Valcour
- The Global Brain Health Institute (GBHI), University of California, San Francisco, San Francisco, CA, United States
- The Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Bruce L. Miller
- The Global Brain Health Institute (GBHI), University of California, San Francisco, San Francisco, CA, United States
- The Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
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15
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Guerrero Barragán A, Lucumí D, Lawlor B. Association of Leisure Activities With Cognitive Impairment and Dementia in Older Adults in Colombia: A SABE-Based Study. Front Neurol 2021; 12:629251. [PMID: 33732207 PMCID: PMC7956952 DOI: 10.3389/fneur.2021.629251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 01/26/2021] [Indexed: 01/16/2023] Open
Abstract
Observational and interventional studies suggest that participation in leisure activities may help protect against cognitive decline in older people. This study aimed to examine the association between participation in leisure activities and cognitive impairment in older adults in Colombia. Data for this study were derived from the Colombian National Survey of Aging (SABE 2015), a cross-sectional survey with a sample size of 23,694 older adults representing the total population (mean age, 70.8 years; 57.3% females). Cognitive impairment was classified as cognitive impairment without dementia (CIWD) and dementia, according to the revised version of the Folstein Mini-Mental State Examination and the Lawton and Brody functional scale. Leisure activities were evaluated using six items of a questionnaire. Sex-stratified multinomial regression models were used to analyze the association of leisure activities with CIWD and dementia after adjusting for educational attainment, literacy, and other potential confounders. In adjusted models for men, leisure activities in later life were associated with a decreased risk of CIWD (odds ratio [OR], 0.73; 95% confidence interval [CI], 0.68-0.78) and dementia (OR, 0,52; 95% CI, 0.48-0.58). For women, leisure activities in later life were associated with a decreased risk of CIWD (OR, 0.72; 95% CI, 0.66-0.78) and dementia (OR, 0.48; 95% CI, 0.43-0.53). The findings suggest that greater participation in leisure activities in later life may act as a protective factor against CIWD and dementia among older adults in Colombia, independent of educational attainment and literacy.
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Affiliation(s)
- Alejandra Guerrero Barragán
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Escuela de Gobierno, Universidad de los Andes, Bogotá, Colombia.,Unidad de Servicios de Salud Occidente de Kennedy, Servicio de Neurología, Bogotá, Colombia
| | - Diego Lucumí
- Escuela de Gobierno, Universidad de los Andes, Bogotá, Colombia
| | - Brian Lawlor
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Department of Psychiatry, Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland
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16
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Parra MA, Baez S, Sedeño L, Gonzalez Campo C, Santamaría‐García H, Aprahamian I, Bertolucci PHF, Bustin J, Camargos Bicalho MA, Cano‐Gutierrez C, Caramelli P, Chaves MLF, Cogram P, Beber BC, Court FA, de Souza LC, Custodio N, Damian A, de la Cruz M, Diehl Rodriguez R, Brucki SMD, Fajersztajn L, Farías GA, De Felice FG, Ferrari R, de Oliveira FF, Ferreira ST, Ferretti C, Figueredo Balthazar ML, Ferreira Frota NA, Fuentes P, García AM, Garcia PJ, de Gobbi Porto FH, Duque Peñailillo L, Engler HW, Maier I, Mata IF, Gonzalez‐Billault C, Lopez OL, Morelli L, Nitrini R, Quiroz YT, Guerrero Barragan A, Huepe D, Pio FJ, Suemoto CK, Kochhann R, Kochen S, Kumfor F, Lanata S, Miller B, Mansur LL, Hosogi ML, Lillo P, Llibre Guerra J, Lira D, Lopera F, Comas A, Avila‐Funes JA, Sosa AL, Ramos C, Resende EDPF, Snyder HM, Tarnanas I, Yokoyama J, Llibre J, Cardona JF, Possin K, Kosik KS, Montesinos R, Moguilner S, Solis PCL, Ferretti‐Rebustini REDL, Ramirez JM, Matallana D, Mbakile‐Mahlanza L, Marques Ton AM, Tavares RM, Miotto EC, Muniz‐Terrera G, Muñoz‐Nevárez LA, Orozco D, Okada de Oliveira M, Piguet O, Pintado Caipa M, Piña Escudero SD, Schilling LP, Rodrigues Palmeira AL, Yassuda MS, Santacruz‐Escudero JM, Serafim RB, Smid J, Slachevsky A, Serrano C, Soto‐Añari M, Takada LT, Grinberg LT, Teixeira AL, Barbosa MT, Trépel D, Ibanez A. Dementia in Latin America: Paving the way toward a regional action plan. Alzheimers Dement 2021; 17:295-313. [PMID: 33634602 PMCID: PMC7984223 DOI: 10.1002/alz.12202] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/28/2020] [Accepted: 08/30/2020] [Indexed: 12/12/2022]
Abstract
Across Latin American and Caribbean countries (LACs), the fight against dementia faces pressing challenges, such as heterogeneity, diversity, political instability, and socioeconomic disparities. These can be addressed more effectively in a collaborative setting that fosters open exchange of knowledge. In this work, the Latin American and Caribbean Consortium on Dementia (LAC-CD) proposes an agenda for integration to deliver a Knowledge to Action Framework (KtAF). First, we summarize evidence-based strategies (epidemiology, genetics, biomarkers, clinical trials, nonpharmacological interventions, networking, and translational research) and align them to current global strategies to translate regional knowledge into transformative actions. Then we characterize key sources of complexity (genetic isolates, admixture in populations, environmental factors, and barriers to effective interventions), map them to the above challenges, and provide the basic mosaics of knowledge toward a KtAF. Finally, we describe strategies supporting the knowledge creation stage that underpins the translational impact of KtAF.
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Affiliation(s)
- Mario Alfredo Parra
- School of Psychological Sciences and HealthGraham Hills BuildingGlasgow, G1 1QE, UK, Universidad Autónoma del CaribePrograma de PsicologíaUniversity of StrathclydeBarranquillaColombia
| | | | - Lucas Sedeño
- Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET)Buenos AiresArgentina
| | - Cecilia Gonzalez Campo
- Cognitive Neuroscience Center (CNC)Universidad de San AndresConsejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET)Buenos AiresArgentina
| | - Hernando Santamaría‐García
- Pontificia Universidad JaverianaMedical School, Physiology and Psychiatry DepartmentsMemory and Cognition Center IntellectusHospital Universitario San IgnacioBogotáColombia
| | - Ivan Aprahamian
- Department of Internal MedicineFaculty of Medicine of JundiaíGroup of Investigation on Multimorbidity and Mental Health in Aging (GIMMA)JundiaíState of São PauloBrazil
| | - Paulo HF Bertolucci
- Department of Neurology and NeurosurgeryEscola Paulista de MedicinaFederal University of São Paulo ‐ UNIFESPSão PauloBrazil
| | - Julian Bustin
- INECO FoundationInstitute of Cognitive and Translational Neuroscience (INCYT)Favaloro UniversityBuenos AiresArgentina
| | | | - Carlos Cano‐Gutierrez
- Medical SchoolGeriatric Unit, Memory and Cognition Center‐IntellectusAging InstituteHospital Universitario San IgnacioPontificia Universidad JaverianaBogotáColombia
| | - Paulo Caramelli
- Faculdade de MedicinaUniversidade Federal de Minas GeraisBelo HorizonteBrazil
| | - Marcia L. F. Chaves
- Neurology ServiceHospital de Clínicas de Porto Alegre e Universidade Federal do Rio Grande do SulBrazil
| | - Patricia Cogram
- Laboratory of Molecular NeuropsychiatryINECO FoundationNational Scientific and Technical Research CouncilInstitute of Cognitive and Translational Neuroscience (INCyT)Favaloro UniversityBuenos AiresArgentina
| | - Bárbara Costa Beber
- Department of Speech and Language PathologyAtlantic Fellow for Equity in Brain HealthFederal University of Health Sciences of Porto Alegre (UFCSPA)Porto AlegreBrazil
| | - Felipe A. Court
- Center for Integrative BiologyFaculty of SciencesFONDAP Center for GeroscienceBrain Health and Metabolism, Santiago, Chile, The Buck Institute for Research on AgingUniversidad Mayor, ChileNovatoCAUSA
| | | | - Nilton Custodio
- Unit Cognitive Impairment and Dementia PreventionCognitive Neurology CenterPeruvian Institute of NeurosciencesLimaPerú
| | - Andres Damian
- Centro Uruguayo de Imagenología Molecular (CUDIM)Centro de Medicina Nuclear e Imagenología MolecularHospital de ClínicasUniversidad de la RepúblicaMontevideoUruguay
| | - Myriam de la Cruz
- Global Brain Health Institute, University of CaliforniaSan FranciscoUSA
| | - Roberta Diehl Rodriguez
- Behavioral and Cognitive Neurology UnitDepartment of Neurology and LIM 22University of São PauloSão PauloBrazil
| | | | - Lais Fajersztajn
- Laboratory of Experimental Air Pollution (LIM05)Department of PathologySchool of MedicineGlobal Brain Health Institute, University of CaliforniaSan Francisco (UCSF)University of São PauloSão PauloSao PauloBrazil
| | - Gonzalo A. Farías
- Department Neurology and Neurosurgery North/Department of NeurosciencesCenter for Advanced Clinical Research (CICA)Faculty of MedicineUniversidad de ChileSantiagoChile
| | | | - Raffaele Ferrari
- Department of Neurodegenerative DiseaseUniversity College LondonLondonESUK
| | - Fabricio Ferreira de Oliveira
- Department of Neurology and NeurosurgeryEscola Paulista de MedicinaFederal University of São Paulo ‐ UNIFESPSão PauloBrazil
| | - Sergio T. Ferreira
- Institute of Medical Biochemistry Leopoldo de Meis & Institute of Biophysics Carlos Chagas FilhoFederal University of Rio de JaneiroRio de JaneiroRJBrazil
| | - Ceres Ferretti
- Division of NeurologyUniversity of São PauloSão PauloBrazil
| | | | | | - Patricio Fuentes
- Geriatrics Section Clinical Hospital University of Chile, Santos Dumont 999 IndependenciaSantiagoChile
| | - Adolfo M. García
- Cognitive Neuroscience Center (CNC)Faculty of EducationNational University of Cuyo (UNCuyo)Universidad de San Andres. National Scientific and Technical Research Council (CONICET)MendozaArgentina
| | | | - Fábio Henrique de Gobbi Porto
- Laboratory of Psychiatric Neuroimaging (LIM‐21)Instituto de PsiquiatriaHospital das Clinicas HCFMUSPFaculdade de MedicinaUniversidade de Sao PauloSao PauloSao PauloBrazil
| | | | | | | | - Ignacio F. Mata
- Department of Genomic MedicineLerner Research InstituteCleveland ClinicOHUSA
| | - Christian Gonzalez‐Billault
- Center for GeroscienceBrain Health and Metabolism (GERO), Santiago, Chile, and Department of Biology, Faculty of SciencesUniversity of ChileSantiagoChile
| | - Oscar L. Lopez
- Alzheimer's Disease Research CenterUniversity of PittsburghPittsburghPAUSA
| | - Laura Morelli
- Fundacion Instituto Leloir‐IIBBA‐CONICET. AveArgentina
| | - Ricardo Nitrini
- Department of NeurologyUniversity of São Paulo Medical SchoolSão PauloBrazil
| | | | - Alejandra Guerrero Barragan
- Trinity College Dublin, Dublin, Departamento de Neurologia Hospital Occidente de KennedyGlobal Brain Health InstituteUniversidad de la SabanaBogotaColombia
| | - David Huepe
- Center for Social and Cognitive Neuroscience (CSCN)School of PsychologyUniversidad Adolfo IbañezSantiagoChile
| | - Fabricio Joao Pio
- Department of NeurologyHospital Governador Celso RamosFlorianopolisBrazil
| | | | - Renata Kochhann
- Graduate Program in PsychologySchool of Health SciencesHospital Moinhos de VentoPontifical Catholic University of Rio Grande do Sul—PUCRS and Researcher OfficePorto AlegreBrazil
| | - Silvia Kochen
- Neurosciences and Complex Systems Unit (EnyS), CONICET, Hosp, El Cruce “N. Kirchner”, Univ. National A, Jauretche (UNAJ), F. Varela, Prov. Buenos Aires. Fac. MedicineUniv Nacional de Buenos Aires (UBA)Buenos AiresArgentina
| | - Fiona Kumfor
- Brain and Mind Centre and School of PsychologyUniversity of SydneySydneyNSWAustralia
| | - Serggio Lanata
- UCSF Department of NeurologyMemory and Aging CenterUCSFSan FranciscoCaliforniaUS
| | - Bruce Miller
- UCSF Department of NeurologyMemory and Aging CenterUCSFSan FranciscoCaliforniaUS
| | | | - Mirna Lie Hosogi
- Behavioral and Cognitive Unit of Department of NeurologyUniversity of São Paulo School of MedicineSao PauloBrazil
| | - Patricia Lillo
- Geroscience Center for Brain Health and Metabolism, Santiago, Chile, Departamento de Neurología Sur/Departamento de Neurociencia, Facultad de MedicinaUniversidad de ChileSantiagoChile
| | | | - David Lira
- Unit Cognitive Impairment and Dementia PreventionCognitive Neurology CenterPeruvian Institute of NeurosciencesLimaPerú
| | - Francisco Lopera
- Neuroscience Research GroupUniversidad de AntioquiaMedellínColombia
| | - Adelina Comas
- Department of Health Policy at the London School of Economics and Political ScienceLondonUK
| | | | - Ana Luisa Sosa
- Instituto Nacional de Neurología y NeurocirugíaCiudad de MéxicoMéxico
| | - Claudia Ramos
- Global Brain Health Institute, University of California, San Francisco (UCSF)San FranciscoUSA
| | | | | | - Ioannis Tarnanas
- Global Brain Health Institute, University of CaliforniaSan FranciscoUSA
- Altoida Inc.HoustonTexasUSA
| | - Jenifer Yokoyama
- UCSF Department of NeurologyMemory and Aging CenterUCSFSan FranciscoCaliforniaUS
| | | | | | - Kate Possin
- UCSF Department of NeurologyMemory and Aging CenterUCSFSan FranciscoCaliforniaUS
| | - Kenneth S. Kosik
- Neuroscience Research Institute and Dept of Molecular Cellular and Developmental BiologyUniversity of California SantaBarbaraCaliforniaUSA
| | - Rosa Montesinos
- Unit Cognitive Impairment and Dementia PreventionCognitive Neurology CenterPeruvian Institute of NeurosciencesLimaPerú
| | - Sebastian Moguilner
- Global Brain Health Institute, University of California, San Francisco (UCSF)San FranciscoUSA
| | - Patricia Cristina Lourdes Solis
- Neurosciences and Complex Systems Unit (EnyS), CONICET, Hosp, El Cruce “N. Kirchner”, Univ. National A, Jauretche (UNAJ), F. Varela, Prov. Buenos Aires. Fac. MedicineUniv Nacional de Buenos Aires (UBA)Buenos AiresArgentina
| | | | - Jeronimo Martin Ramirez
- Departamen de Admision Continua Adultos Hospital General La Raza Instituto Mexicano del Seguro SocialGlobal Brain Health Institute, Trinity College Dublin, DublinCiudad de MexicoMexico
| | - Diana Matallana
- Medical SchoolAging Institute and Psychiatry DepartmentPontificia Universidad Javeriana. Memory and Cognition Center‐IntellectusHospital Universitario San IgnacioBogotáColombia
| | - Lingani Mbakile‐Mahlanza
- Global Brain Health InstituteUniversity of California San Francisco, University of BotswanaGaboroneBotswana
| | | | | | - Eliane C Miotto
- Department of NeurologyUniversity of Sao PauloSao PauloBrazil
| | | | | | - David Orozco
- Cognitive Neuroscience Development LaboratoryAxis NeurocienciasUniversidad Nacional del Sur, Cognitive Impairment and Behavior Disorders UnitBahía BlancaArgentina
| | - Maira Okada de Oliveira
- Global Brain Health Institute, University of California, San Francisco (UCSF)San FranciscoUSA
| | - Olivier Piguet
- School of Psychology and Brain and Mind CentreUniversity of SydneyCamperdownNSWAustralia
| | - Maritza Pintado Caipa
- Global Brain Health Institute, University of California, San Francisco (UCSF)San FranciscoUSA
| | | | - Lucas Porcello Schilling
- Department of NeurologyPontificia Universidade Catolica do Rio Grande do Sul (PUCRS)Porto AlegreBrazil
| | - André Luiz Rodrigues Palmeira
- Santa Casa de Misericórdia de Porto Alegre, Serviço de Neurologia, Porto Alegre, BrazilHospital Ernesto DornellesServiço de Neurologia e NeurocirurgiaPorto AlegreBrazil
| | | | - Jose Manuel Santacruz‐Escudero
- Medical School and Psychiatry DepartmentMemory and Cognition Center‐ IntellectusPontificia Universidad JaverianaHospital Universitario San IgnacioBogotáColombia
| | | | - Jerusa Smid
- Department of NeurologyUniversity of Sao PauloSão PauloBrazil
| | - Andrea Slachevsky
- Neurology DepartmentGeroscience Center for Brain Health and Metabolism, Santiago, Chile, Laboratory of Neuropsychology and Clinical Neuroscience (LANNEC), Physiopathology Program‐ICBM, East Neurologic and Neurosciences Departments, Faculty of MedicineHospital del Salvador and Faculty of Medicine University of Chile. Servicio de NeurologíaDepartamento de MedicinaClínica Alemana—Universidad del DesarrolloUniversity of Chile, Neuropsychiatry and Memory Disorders clinic (CMYN)SantiagoChile
| | | | | | | | - Lea Tenenholz Grinberg
- Departments of NeurologyPathology and Global Brain Health InstituteUCSF ‐ USA, Department of PathologyUniversity of São Paulo Medical SchoolSão PauloBrazil
| | - Antonio Lucio Teixeira
- Laboratório Interdisciplinar de Investigação MédicaFaculdade de MedicinaAv. Alfredo Balena, 110Universidade Federal de Minas GeraisBelo HorizonteBrazil
| | - Maira Tonidandel Barbosa
- Faculdade de Medicina da Universidade Federal de Minas Gerais e Faculdade deCiências Médicas de Minas GeraisBelo HorizonteBrazil
| | - Dominic Trépel
- Global Brain Health Institute (GBHI)Trinity College DublinDublin
| | - Agustin Ibanez
- Cognitive Neuroscience Center (CNC) Buenos Aires, Argentina; Universidad Autonoma del Caribe, Barranquilla, Colombia; Global Brain Health Institute (GBHI), USUniversidad de San AndresCONICETUniversidad Autonoma del CaribeUniversidad Adolfo IbanezUCSFUSA
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17
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Moguilner S, García AM, Perl YS, Tagliazucchi E, Piguet O, Kumfor F, Reyes P, Matallana D, Sedeño L, Ibáñez A. Dynamic brain fluctuations outperform connectivity measures and mirror pathophysiological profiles across dementia subtypes: A multicenter study. Neuroimage 2021; 225:117522. [PMID: 33144220 PMCID: PMC7832160 DOI: 10.1016/j.neuroimage.2020.117522] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 10/14/2020] [Accepted: 10/27/2020] [Indexed: 02/07/2023] Open
Abstract
From molecular mechanisms to global brain networks, atypical fluctuations are the hallmark of neurodegeneration. Yet, traditional fMRI research on resting-state networks (RSNs) has favored static and average connectivity methods, which by overlooking the fluctuation dynamics triggered by neurodegeneration, have yielded inconsistent results. The present multicenter study introduces a data-driven machine learning pipeline based on dynamic connectivity fluctuation analysis (DCFA) on RS-fMRI data from 300 participants belonging to three groups: behavioral variant frontotemporal dementia (bvFTD) patients, Alzheimer's disease (AD) patients, and healthy controls. We considered non-linear oscillatory patterns across combined and individual resting-state networks (RSNs), namely: the salience network (SN), mostly affected in bvFTD; the default mode network (DMN), mostly affected in AD; the executive network (EN), partially compromised in both conditions; the motor network (MN); and the visual network (VN). These RSNs were entered as features for dementia classification using a recent robust machine learning approach (a Bayesian hyperparameter tuned Gradient Boosting Machines (GBM) algorithm), across four independent datasets with different MR scanners and recording parameters. The machine learning classification accuracy analysis revealed a systematic and unique tailored architecture of RSN disruption. The classification accuracy ranking showed that the most affected networks for bvFTD were the SN + EN network pair (mean accuracy = 86.43%, AUC = 0.91, sensitivity = 86.45%, specificity = 87.54%); for AD, the DMN + EN network pair (mean accuracy = 86.63%, AUC = 0.89, sensitivity = 88.37%, specificity = 84.62%); and for the bvFTD vs. AD classification, the DMN + SN network pair (mean accuracy = 82.67%, AUC = 0.86, sensitivity = 81.27%, specificity = 83.01%). Moreover, the DFCA classification systematically outperformed canonical connectivity approaches (including both static and linear dynamic connectivity). Our findings suggest that non-linear dynamical fluctuations surpass two traditional seed-based functional connectivity approaches and provide a pathophysiological characterization of global brain networks in neurodegenerative conditions (AD and bvFTD) across multicenter data.
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Affiliation(s)
- Sebastian Moguilner
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), California, US; & Trinity College Dublin, Dublin, Ireland; Fundación Escuela de Medicina Nuclear (FUESMEN) and Comisión Nacional de Energía Atómica (CNEA), Buenos Aires, Argentina
| | - Adolfo M García
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), California, US; & Trinity College Dublin, Dublin, Ireland; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Universidad de San Andrés, Buenos Aires, Argentina; Faculty of Education, National University of Cuyo (UNCuyo), Mendoza, Argentina
| | - Yonatan Sanz Perl
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Universidad de San Andrés, Buenos Aires, Argentina; Department of Physics, University of Buenos Aires, Argentina
| | - Enzo Tagliazucchi
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Department of Physics, University of Buenos Aires, Argentina
| | - Olivier Piguet
- School of Psychology and Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Fiona Kumfor
- School of Psychology and Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Pablo Reyes
- Medical School, Aging Institute, Psychiatry and Mental Health, Pontificia Universidad Javeriana; Mental Health Unit, Hospital Universitario Fundación Santa Fe, Bogotá, Colombia, Hospital Universitario San Ignacio. Bogotá, Colombia
| | - Diana Matallana
- Medical School, Aging Institute, Psychiatry and Mental Health, Pontificia Universidad Javeriana; Mental Health Unit, Hospital Universitario Fundación Santa Fe, Bogotá, Colombia, Hospital Universitario San Ignacio. Bogotá, Colombia
| | - Lucas Sedeño
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.
| | - Agustín Ibáñez
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), California, US; & Trinity College Dublin, Dublin, Ireland; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Universidad de San Andrés, Buenos Aires, Argentina; Universidad Autónoma del Caribe, Barranquilla, Colombia; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago de Chile, Chile.
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18
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Ibanez A, Flichtentrei D, Hesse E, Dottori M, Tomio A, Slachevsky A, Serrano CM, Gonzalez‐Billaut C, Custodio N, Miranda C, Bustin J, Cetckovitch M, Torrente F, Olavarria L, Leon T, Beber BC, Bruki S, Suemoto CK, Nitrini R, Miller BL, Yokoyama JS. The power of knowledge about dementia in Latin America across health professionals working on aging. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12117. [PMID: 33088898 PMCID: PMC7560513 DOI: 10.1002/dad2.12117] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/01/2020] [Accepted: 09/16/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Expert knowledge is critical to fight dementia in inequitable regions like Latin American and Caribbean countries (LACs). However, the opinions of aging experts on public policies' accessibility and transmission, stigma, diagnostic manuals, data-sharing platforms, and use of behavioral insights (BIs) are not well known. METHODS We investigated opinions among health professionals working on aging in LACs (N = 3365) with regression models including expertise-related information (public policies, BI), individual differences (work, age, academic degree), and location. RESULTS Experts specified low public policy knowledge (X2 = 41.27, P < .001), high levels of stigma (X2 = 2636.37, P < .001), almost absent BI knowledge (X2 = 56.58, P < .001), and needs for regional diagnostic manuals (X2 = 2893.63, df = 3, P < .001) and data-sharing platforms (X2 = 1267.5, df = 3, P < .001). Lack of dementia knowledge was modulated by different factors. An implemented BI-based treatment for a proposed prevention program improved perception across experts. DISCUSSION Our findings help to prioritize future potential actions of governmental agencies and non-governmental organizations (NGOs) to improve LACs' dementia knowledge.
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Affiliation(s)
- Agustin Ibanez
- Global Brain Health Institute and the Memory and Aging Center, Weill Institute for Neurosciences, Department of NeurologyUniversity of California, San Francisco (UCSF)San FranciscoCaliforniaUSA
- Universidad de San AndrésBuenos AiresArgentina
- National Scientific and Technical Research Council (CONICET)Buenos AiresArgentina
- Center for Social and Cognitive Neuroscience (CSCN), School of PsychologyUniversidad Adolfo IbáñezSantiago de ChileChile
- Universidad Autónoma del CaribeBarranquillaColombia
| | | | - Eugenia Hesse
- Universidad de San AndrésBuenos AiresArgentina
- National Scientific and Technical Research Council (CONICET)Buenos AiresArgentina
| | - Martin Dottori
- Universidad de San AndrésBuenos AiresArgentina
- National Scientific and Technical Research Council (CONICET)Buenos AiresArgentina
| | - Ailin Tomio
- Universidad de San AndrésBuenos AiresArgentina
| | - Andrea Slachevsky
- Memory and Neuropsychiatric Clinic (CMYN), Neurology DepartmentDel Salvador Hospital and University of Chile Faculty of MedicineSantiagoChile
- Geroscience Center for Brain Health and Metabolism (GERO), Faculty of MedicineUniversity of ChileSantiagoChile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department ‐ ICBM, Neuroscience and East Neuroscience Departments, Faculty of MedicineUniversity of ChileSantiagoChile
- Department of Neurology and PsychiatryClínica Alemana‐Universidad del DesarrolloSantiagoChile
| | - Cecilia M Serrano
- Cognitive Neurology, Neurology DepartmentDr César Milstein HospitalBuenos AiresArgentina
| | - Christian Gonzalez‐Billaut
- Geroscience Center for Brain Health and Metabolism (GERO), Faculty of MedicineUniversity of ChileSantiagoChile
| | - Nilton Custodio
- Unit Cognitive Impairment and Dementia Prevention, Cognitive Neurology CenterPeruvian Institute of NeurosciencesLimaPerú
| | - Claudia Miranda
- Faculty of NursingUniversidad Andres BelloSantiagoChile
- Millennium Institute for Research in Depression and PersonalitySantiagoChile
| | - Julian Bustin
- Institute of Translational and Cognitive Neuroscience (INCYT), INECO Foundation, Favaloro UniversityNational Scientific and Technical Research Council (CONICET)Buenos AiresArgentina
| | - Marcelo Cetckovitch
- Institute of Translational and Cognitive Neuroscience (INCYT), INECO Foundation, Favaloro UniversityNational Scientific and Technical Research Council (CONICET)Buenos AiresArgentina
| | - Fernando Torrente
- Institute of Translational and Cognitive Neuroscience (INCYT), INECO Foundation, Favaloro UniversityNational Scientific and Technical Research Council (CONICET)Buenos AiresArgentina
| | - Loreto Olavarria
- Memory and Neuropsychiatric Clinic (CMYN), Neurology DepartmentDel Salvador Hospital and University of Chile Faculty of MedicineSantiagoChile
| | - Tomas Leon
- Memory and Neuropsychiatric Clinic (CMYN), Neurology DepartmentDel Salvador Hospital and University of Chile Faculty of MedicineSantiagoChile
| | - Barbara Costa Beber
- Department of Speech and Language Pathology, Federal University of Health Sciences of Porto Alegre (UFCSPA)Atlantic Fellow for Equity in Brain HealthPorto AlegreBrazil
| | - Sonia Bruki
- Faculdade de MedicinaUniversidade de São PauloSão PauloBrazil
| | | | - Ricardo Nitrini
- Faculdade de MedicinaUniversidade de São PauloSão PauloBrazil
| | - Bruce L. Miller
- Global Brain Health Institute and the Memory and Aging Center, Weill Institute for Neurosciences, Department of NeurologyUniversity of California, San Francisco (UCSF)San FranciscoCaliforniaUSA
| | - Jennifer S. Yokoyama
- Global Brain Health Institute and the Memory and Aging Center, Weill Institute for Neurosciences, Department of NeurologyUniversity of California, San Francisco (UCSF)San FranciscoCaliforniaUSA
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Cerebrovascular Correlates of Dementia in Community-Dwelling Older Adults Living in Rural Communities - The Three Villages Study. Rationale and Protocol of a Population-Based Prospective Cohort Study. J Stroke Cerebrovasc Dis 2020; 29:104656. [PMID: 32033904 DOI: 10.1016/j.jstrokecerebrovasdis.2020.104656] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 12/01/2019] [Accepted: 01/09/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Despite the assumption that dementia is increasing in rural areas of Latin America, there is no information on the burden and risk factors leading to dementia in these settings. AIMS To assess prevalence and incidence of dementia, and its cerebrovascular correlates in an established cohort of community-dwelling older adults living in rural Ecuador, and to explore the impact of dementia on functional disability and the role of the social determinants of health in the above-mentioned relationships. DESIGN Population-based, cohort study with cross-sectional and longitudinal components. Baseline clinical interviews will focus on the assessment of cognitive performance and dementia by means of the clinical dementia rating scale (CDRS). Functional disability and social determinants of health will be correlated with CDRS scores. In addition, participants will undergo interviews and procedures to assess cardiovascular risk factors and signatures of brain damage, cerebral small vessel disease, and other stroke subtypes. The CDRS and the Functional Activities Questionnaire will be administered every year to assess the rate of incident dementia and the severity of functional disability. Neuroimaging studies will be repeated at the end of the study (5 years) to assess the impact of newly appeared cerebral and vascular lesions on cognitive decline. COMMENT This study will allow determine whether cerebrovascular diseases are in the path of dementia development in these rural settings. This may prove cost-effective for the development of preventive strategies aimed to control modifiable factors and reduce disability in patients with dementia living in underserved populations.
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Del Brutto OH, Mera RM, Recalde BY, Del Brutto VJ. Carotid Intima-media Thickness, Cognitive Performance and Cognitive Decline in Stroke-free Middle-aged and Older Adults. The Atahualpa Project. J Stroke Cerebrovasc Dis 2020; 29:104576. [DOI: 10.1016/j.jstrokecerebrovasdis.2019.104576] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 11/24/2019] [Indexed: 12/16/2022] Open
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Del Brutto OH, Mera RM, Zambrano M. Cognitive decline is not influenced by the marital status or living arrangements in community-dwelling adults living in a rural setting. A population-based prospective cohort study. J Clin Neurosci 2019; 69:109-113. [PMID: 31466904 DOI: 10.1016/j.jocn.2019.08.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 08/04/2019] [Indexed: 01/30/2023]
Abstract
Little is known on factors influencing cognitive decline in rural communities. Using the Atahualpa Project cohort, we aimed to assess whether the marital status or living arrangements influenced cognitive decline in community-dwelling adults living in an Ecuadorian rural village. The study included 629 Atahualpa residents aged ≥40 years who had a follow-up Montreal Cognitive Assessment (MoCA) repeated at least one year after baseline. Multivariate longitudinal linear models were fitted to assess differences between the marital status and living arrangements and cognitive decline (as the outcome). A total of 411 participants were married. The remaining 218 were either single, divorced or widowed (191 of them lived with family members and the others lived alone). Enrolled individuals contributed 2088.4 person-years of follow-up (mean: 3.3 ± 1.1 years). The mean baseline MoCA was 22.1 ± 4.5 points and the follow-up MoCA was 20.6 ± 4.8 points (p = 0.001). Overall, 394 (63%) individuals had lower MoCA scores at follow-up. A fully-adjusted longitudinal linear model showed no differences in MoCA decline across married and non-married individuals (β: -0.15; 95% C.I.: -0.55 - 0.26; p = 0.477). When the subset of non-married individuals was taken into account for analyses, multivariate longitudinal linear models showed no differences in the severity of cognitive decline across individuals living alone versus those living with family members (β: 0.28; 95% C.I.: -0.68 - 1.24; p = 0.572). In this study, the marital status or living arrangements had no influence on cognitive decline in the follow-up.
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Affiliation(s)
- Oscar H Del Brutto
- School of Medicine, Universidad Espíritu Santo - Ecuador, Samborondón, Ecuador.
| | - Robertino M Mera
- Department of Epidemiology, Gilead Sciences, Inc., Foster City, CA, USA
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22
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Perales-Puchalt J, Vidoni ML, Rodríguez JL, Vidoni ED, Billinger S, Burns J, Guerchet M, Lee M. Cardiovascular health and dementia incidence among older adults in Latin America: Results from the 10/66 study. Int J Geriatr Psychiatry 2019; 34:1041-1049. [PMID: 30908765 PMCID: PMC6579616 DOI: 10.1002/gps.5107] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 03/17/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Growing evidence shows that cardiovascular health (CVH) is associated with brain health. Little is known about this topic among older adults in Latin America, where the number of people living with dementia is rising. This study aimed to assess the longitudinal association between CVH and dementia in six Latin American countries. METHODS We analyzed longitudinal data from the 10/66 study that included nondementia residents at baseline aged 65+ in six Latin American countries (n = 6447) and were followed up for 3 years. An index of modifiable CVH factors (ranging from 0 to 14) was calculated. Incident dementia was modeled using competing risk regression to adjust for risk of death. RESULTS The sample included 6.2% participants with poor (0-5), 81.0% with moderate (6-10), and 12.8% with ideal CVH (11-14). At follow-up, 9.4% had developed dementia and 13.1% had died. Compared with those with poor CVH, participants with moderate and ideal levels of CVH had a significantly lower risk of dementia in both the unadjusted (subhazard ratio for moderate, 0.77; ideal, 0.59) and adjusted models (moderate, 0.73; ideal, 0.66). CONCLUSION Moderate and ideal levels of CVH in old age may protect against dementia incidence. These findings may inform health promotion efforts within dementia national plans adopted recently in some Latin American countries.
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Affiliation(s)
| | | | - Juan Llibre Rodríguez
- Facultad de Medicina Finley-Albarrán, Universidad de Ciencias Médicas de la Habana, Habana, 11500, Cuba
| | - Eric D Vidoni
- University of Kansas Alzheimer’s Disease Center, MS6002, Fairway, KS 66205, USA
| | - Sandra Billinger
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Jeffrey Burns
- University of Kansas Alzheimer’s Disease Center, MS6002, Fairway, KS 66205, USA
| | - Maëlenn Guerchet
- King’s College London, Centre for Global Mental Health, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF, United Kingdom
| | - MinJae Lee
- The University of Texas Health Science Center at Houston, McGovern Medical School; Houston, TX 77030, USA
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Del Brutto OH, Mera RM, Del Brutto VJ, Zambrano M, Wright CB, Rundek T. Clinical and neuroimaging risk factors for cognitive decline in community-dwelling older adults living in rural Ecuador. A population-based prospective cohort study. Int J Geriatr Psychiatry 2019; 34:447-452. [PMID: 30474242 PMCID: PMC6372307 DOI: 10.1002/gps.5037] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 11/14/2018] [Indexed: 01/26/2023]
Abstract
OBJECTIVE There is limited information on factors influencing cognitive decline in rural settings from low- and middle-income countries. Using the Atahualpa Project cohort, we aimed to assess the burden of cognitive decline in older adults living in a rural Ecuadorian village. METHODS The study included Atahualpa residents aged greater than or equal to 60 years who had a follow-up Montreal Cognitive Assessment (MoCA) repeated at least 1 year after baseline. MoCA decline was assessed by multivariable longitudinal linear models, adjusted for demographics, days between MoCA tests, cardiovascular risk factors, and neuroimaging signatures of structural brain damage. RESULTS We included 252 individuals who contributed 923.7 person-years of follow-up (mean: 3.7 ± 0.7 years). The mean baseline MoCA was 19.5 ± 4.5 points, and the follow-up MoCA was 18.1 ± 4.9 points (P = 0.001). Overall, 154 individuals (61%) had lower MoCA scores at follow-up. The best fitted longitudinal linear model showed a decline of follow-up MoCA from baseline (β: 0.14; 95% CI, 0.0-0.21; P < 0.001). High glucose levels, global cortical atrophy, and white matter hyperintensities were independently and significantly associated with greater MoCA decline. CONCLUSION This study provides evidence of cognitive decline in older adults living in a rural setting. Main targets for prevention should include glucose control and the control of factors that are deleterious for the development of cortical atrophy and white matter hyperintensities.
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Affiliation(s)
- Oscar H. Del Brutto
- School of Medicine, Universidad Espíritu Santo – Ecuador, Guayaquil, Ecuador
| | | | - Victor J. Del Brutto
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, Fl, USA
| | | | - Clinton B. Wright
- National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - Tatjana Rundek
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, Fl, USA
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The long-lived Octodon degus as a rodent drug discovery model for Alzheimer's and other age-related diseases. Pharmacol Ther 2018. [PMID: 29514054 DOI: 10.1016/j.pharmthera.2018.03.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Alzheimer's disease (AD) is a multifactorial progressive neurodegenerative disease. Despite decades of research, no disease modifying therapy is available and a change of research objectives and/or development of novel research tools may be required. Much AD research has been based on experimental models using animals with a short lifespan that have been extensively genetically manipulated and do not represent the full spectrum of late-onset AD, which make up the majority of cases. The aetiology of AD is heterogeneous and involves multiple factors associated with the late-onset of the disease like disturbances in brain insulin, oxidative stress, neuroinflammation, metabolic syndrome, retinal degeneration and sleep disturbances which are all progressive abnormalities that could account for many molecular, biochemical and histopathological lesions found in brain from patients dying from AD. This review is based on the long-lived rodent Octodon degus (degu) which is a small diurnal rodent native to South America that can spontaneously develop cognitive decline with concomitant phospho-tau, β-amyloid pathology and neuroinflammation in brain. In addition, the degu can also develop several other conditions like type 2 diabetes, macular and retinal degeneration and atherosclerosis, conditions that are often associated with aging and are often comorbid with AD. Long-lived animals like the degu may provide a more realistic model to study late onset AD.
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25
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Parra MA, Baez S, Allegri R, Nitrini R, Lopera F, Slachevsky A, Custodio N, Lira D, Piguet O, Kumfor F, Huepe D, Cogram P, Bak T, Manes F, Ibanez A. Dementia in Latin America: Assessing the present and envisioning the future. Neurology 2018; 90:222-231. [PMID: 29305437 PMCID: PMC5791795 DOI: 10.1212/wnl.0000000000004897] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 10/02/2017] [Indexed: 01/26/2023] Open
Abstract
The demographic structure of Latin American countries (LAC) is fast approaching that of developing countries, and the predicted prevalence of dementia in the former already exceeds the latter. Dementia has been declared a global challenge, yet regions around the world show differences in both the nature and magnitude of such a challenge. This article provides evidence and insights on barriers which, if overcome, would enable the harmonization of strategies to tackle the dementia challenge in LAC. First, we analyze the lack of available epidemiologic data, the need for standardizing clinical practice and improving physician training, and the existing barriers regarding resources, culture, and stigmas. We discuss how these are preventing timely care and research. Regarding specific health actions, most LAC have minimal mental health facilities and do not have specific mental health policies or budgets specific to dementia. In addition, local regulations may need to consider the regional context when developing treatment and prevention strategies. The support needed nationally and internationally to enable a smooth and timely transition of LAC to a position that integrates global strategies is highlighted. We focus on shared issues of poverty, cultural barriers, and socioeconomic vulnerability. We identify avenues for collaboration aimed to study unique populations, improve valid assessment methods, and generate opportunities for translational research, thus establishing a regional network. The issues identified here point to future specific actions aimed at tackling the dementia challenge in LAC.
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Affiliation(s)
- Mario A Parra
- From the School of Life Sciences (M.A.P.), Psychology, University Heriot-Watt; Human Cognitive Neuroscience (M.A.P.), Psychology, Edinburgh University; Alzheimer's Scotland Dementia Research Centre and Scottish Dementia Clinical Research Network (M.A.P.), Edinburgh; Centre for Cognitive Ageing and Cognitive Epidemiology (M.A.P., T.B.) and Department of Psychology, School of Philosophy, Psychology and Language Sciences (P.C., T.B.), University of Edinburgh, UK; Universidad Autónoma del Caribe (M.A.P., A.I.), Barranquilla, Colombia; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) (S.B., F.M., A.I.); Institute of Translational and Cognitive Neuroscience (INCYT) (S.B., F.M., A.I.), INECO Foundation, Favaloro University, Buenos Aires, Argentina; Departamento de Psicología (S.B.) Universidad de los Andes, Bogotá, Colombia; Department of Cognitive Neurology and Neuropsychology (R.A.), Instituto de Investigaciones Neurológicas "Raúl Carrea" (FLENI) (R.A.), Buenos Aires, Argentina; Universidad de la Costa (CUC) (R.A.), Barranquilla, Colombia; Department of Neurology (R.N.), University of São Paulo Medical School, Brazil; Group of Neuroscience (F.L.), University of Antioquia, Medellín, Colombia; Geroscience Center for Brain Health and Metabolism (A.S.); Physiopathology Department, ICBM, and East Neuroscience Department, Faculty of Medicine (A.S.), and Center for Advanced Research in Education (CIAE) (A.S.), University of Chile; Cognitive Neurology and Dementia, Neurology Department (A.S.), Hospital del Salvador; Neurology Department, Clínica Alemana (A.S.), Santiago, Chile; Research Unit, Peruvian Institute of Neurosciences (N.C., D.L.) and Unit Cognitive Impairment and Dementia Prevention (N.C., D.L.), Lima, Peru; Brain and Mind Centre & School of Psychology (O.P., F.K.), Faculty of Science, University of Sydney; ARC Centre of Excellence in Cognition and its Disorders (O.P., F.K., F.M., A.I.), Sydney, Australia; Fraunhofer Chile (O.P., P.C.), Santiago; and Center for Social and Cognitive Neuroscience (CSCN), School of Psychology (D.H., A.I.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Sandra Baez
- From the School of Life Sciences (M.A.P.), Psychology, University Heriot-Watt; Human Cognitive Neuroscience (M.A.P.), Psychology, Edinburgh University; Alzheimer's Scotland Dementia Research Centre and Scottish Dementia Clinical Research Network (M.A.P.), Edinburgh; Centre for Cognitive Ageing and Cognitive Epidemiology (M.A.P., T.B.) and Department of Psychology, School of Philosophy, Psychology and Language Sciences (P.C., T.B.), University of Edinburgh, UK; Universidad Autónoma del Caribe (M.A.P., A.I.), Barranquilla, Colombia; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) (S.B., F.M., A.I.); Institute of Translational and Cognitive Neuroscience (INCYT) (S.B., F.M., A.I.), INECO Foundation, Favaloro University, Buenos Aires, Argentina; Departamento de Psicología (S.B.) Universidad de los Andes, Bogotá, Colombia; Department of Cognitive Neurology and Neuropsychology (R.A.), Instituto de Investigaciones Neurológicas "Raúl Carrea" (FLENI) (R.A.), Buenos Aires, Argentina; Universidad de la Costa (CUC) (R.A.), Barranquilla, Colombia; Department of Neurology (R.N.), University of São Paulo Medical School, Brazil; Group of Neuroscience (F.L.), University of Antioquia, Medellín, Colombia; Geroscience Center for Brain Health and Metabolism (A.S.); Physiopathology Department, ICBM, and East Neuroscience Department, Faculty of Medicine (A.S.), and Center for Advanced Research in Education (CIAE) (A.S.), University of Chile; Cognitive Neurology and Dementia, Neurology Department (A.S.), Hospital del Salvador; Neurology Department, Clínica Alemana (A.S.), Santiago, Chile; Research Unit, Peruvian Institute of Neurosciences (N.C., D.L.) and Unit Cognitive Impairment and Dementia Prevention (N.C., D.L.), Lima, Peru; Brain and Mind Centre & School of Psychology (O.P., F.K.), Faculty of Science, University of Sydney; ARC Centre of Excellence in Cognition and its Disorders (O.P., F.K., F.M., A.I.), Sydney, Australia; Fraunhofer Chile (O.P., P.C.), Santiago; and Center for Social and Cognitive Neuroscience (CSCN), School of Psychology (D.H., A.I.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Ricardo Allegri
- From the School of Life Sciences (M.A.P.), Psychology, University Heriot-Watt; Human Cognitive Neuroscience (M.A.P.), Psychology, Edinburgh University; Alzheimer's Scotland Dementia Research Centre and Scottish Dementia Clinical Research Network (M.A.P.), Edinburgh; Centre for Cognitive Ageing and Cognitive Epidemiology (M.A.P., T.B.) and Department of Psychology, School of Philosophy, Psychology and Language Sciences (P.C., T.B.), University of Edinburgh, UK; Universidad Autónoma del Caribe (M.A.P., A.I.), Barranquilla, Colombia; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) (S.B., F.M., A.I.); Institute of Translational and Cognitive Neuroscience (INCYT) (S.B., F.M., A.I.), INECO Foundation, Favaloro University, Buenos Aires, Argentina; Departamento de Psicología (S.B.) Universidad de los Andes, Bogotá, Colombia; Department of Cognitive Neurology and Neuropsychology (R.A.), Instituto de Investigaciones Neurológicas "Raúl Carrea" (FLENI) (R.A.), Buenos Aires, Argentina; Universidad de la Costa (CUC) (R.A.), Barranquilla, Colombia; Department of Neurology (R.N.), University of São Paulo Medical School, Brazil; Group of Neuroscience (F.L.), University of Antioquia, Medellín, Colombia; Geroscience Center for Brain Health and Metabolism (A.S.); Physiopathology Department, ICBM, and East Neuroscience Department, Faculty of Medicine (A.S.), and Center for Advanced Research in Education (CIAE) (A.S.), University of Chile; Cognitive Neurology and Dementia, Neurology Department (A.S.), Hospital del Salvador; Neurology Department, Clínica Alemana (A.S.), Santiago, Chile; Research Unit, Peruvian Institute of Neurosciences (N.C., D.L.) and Unit Cognitive Impairment and Dementia Prevention (N.C., D.L.), Lima, Peru; Brain and Mind Centre & School of Psychology (O.P., F.K.), Faculty of Science, University of Sydney; ARC Centre of Excellence in Cognition and its Disorders (O.P., F.K., F.M., A.I.), Sydney, Australia; Fraunhofer Chile (O.P., P.C.), Santiago; and Center for Social and Cognitive Neuroscience (CSCN), School of Psychology (D.H., A.I.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Ricardo Nitrini
- From the School of Life Sciences (M.A.P.), Psychology, University Heriot-Watt; Human Cognitive Neuroscience (M.A.P.), Psychology, Edinburgh University; Alzheimer's Scotland Dementia Research Centre and Scottish Dementia Clinical Research Network (M.A.P.), Edinburgh; Centre for Cognitive Ageing and Cognitive Epidemiology (M.A.P., T.B.) and Department of Psychology, School of Philosophy, Psychology and Language Sciences (P.C., T.B.), University of Edinburgh, UK; Universidad Autónoma del Caribe (M.A.P., A.I.), Barranquilla, Colombia; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) (S.B., F.M., A.I.); Institute of Translational and Cognitive Neuroscience (INCYT) (S.B., F.M., A.I.), INECO Foundation, Favaloro University, Buenos Aires, Argentina; Departamento de Psicología (S.B.) Universidad de los Andes, Bogotá, Colombia; Department of Cognitive Neurology and Neuropsychology (R.A.), Instituto de Investigaciones Neurológicas "Raúl Carrea" (FLENI) (R.A.), Buenos Aires, Argentina; Universidad de la Costa (CUC) (R.A.), Barranquilla, Colombia; Department of Neurology (R.N.), University of São Paulo Medical School, Brazil; Group of Neuroscience (F.L.), University of Antioquia, Medellín, Colombia; Geroscience Center for Brain Health and Metabolism (A.S.); Physiopathology Department, ICBM, and East Neuroscience Department, Faculty of Medicine (A.S.), and Center for Advanced Research in Education (CIAE) (A.S.), University of Chile; Cognitive Neurology and Dementia, Neurology Department (A.S.), Hospital del Salvador; Neurology Department, Clínica Alemana (A.S.), Santiago, Chile; Research Unit, Peruvian Institute of Neurosciences (N.C., D.L.) and Unit Cognitive Impairment and Dementia Prevention (N.C., D.L.), Lima, Peru; Brain and Mind Centre & School of Psychology (O.P., F.K.), Faculty of Science, University of Sydney; ARC Centre of Excellence in Cognition and its Disorders (O.P., F.K., F.M., A.I.), Sydney, Australia; Fraunhofer Chile (O.P., P.C.), Santiago; and Center for Social and Cognitive Neuroscience (CSCN), School of Psychology (D.H., A.I.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Francisco Lopera
- From the School of Life Sciences (M.A.P.), Psychology, University Heriot-Watt; Human Cognitive Neuroscience (M.A.P.), Psychology, Edinburgh University; Alzheimer's Scotland Dementia Research Centre and Scottish Dementia Clinical Research Network (M.A.P.), Edinburgh; Centre for Cognitive Ageing and Cognitive Epidemiology (M.A.P., T.B.) and Department of Psychology, School of Philosophy, Psychology and Language Sciences (P.C., T.B.), University of Edinburgh, UK; Universidad Autónoma del Caribe (M.A.P., A.I.), Barranquilla, Colombia; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) (S.B., F.M., A.I.); Institute of Translational and Cognitive Neuroscience (INCYT) (S.B., F.M., A.I.), INECO Foundation, Favaloro University, Buenos Aires, Argentina; Departamento de Psicología (S.B.) Universidad de los Andes, Bogotá, Colombia; Department of Cognitive Neurology and Neuropsychology (R.A.), Instituto de Investigaciones Neurológicas "Raúl Carrea" (FLENI) (R.A.), Buenos Aires, Argentina; Universidad de la Costa (CUC) (R.A.), Barranquilla, Colombia; Department of Neurology (R.N.), University of São Paulo Medical School, Brazil; Group of Neuroscience (F.L.), University of Antioquia, Medellín, Colombia; Geroscience Center for Brain Health and Metabolism (A.S.); Physiopathology Department, ICBM, and East Neuroscience Department, Faculty of Medicine (A.S.), and Center for Advanced Research in Education (CIAE) (A.S.), University of Chile; Cognitive Neurology and Dementia, Neurology Department (A.S.), Hospital del Salvador; Neurology Department, Clínica Alemana (A.S.), Santiago, Chile; Research Unit, Peruvian Institute of Neurosciences (N.C., D.L.) and Unit Cognitive Impairment and Dementia Prevention (N.C., D.L.), Lima, Peru; Brain and Mind Centre & School of Psychology (O.P., F.K.), Faculty of Science, University of Sydney; ARC Centre of Excellence in Cognition and its Disorders (O.P., F.K., F.M., A.I.), Sydney, Australia; Fraunhofer Chile (O.P., P.C.), Santiago; and Center for Social and Cognitive Neuroscience (CSCN), School of Psychology (D.H., A.I.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Andrea Slachevsky
- From the School of Life Sciences (M.A.P.), Psychology, University Heriot-Watt; Human Cognitive Neuroscience (M.A.P.), Psychology, Edinburgh University; Alzheimer's Scotland Dementia Research Centre and Scottish Dementia Clinical Research Network (M.A.P.), Edinburgh; Centre for Cognitive Ageing and Cognitive Epidemiology (M.A.P., T.B.) and Department of Psychology, School of Philosophy, Psychology and Language Sciences (P.C., T.B.), University of Edinburgh, UK; Universidad Autónoma del Caribe (M.A.P., A.I.), Barranquilla, Colombia; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) (S.B., F.M., A.I.); Institute of Translational and Cognitive Neuroscience (INCYT) (S.B., F.M., A.I.), INECO Foundation, Favaloro University, Buenos Aires, Argentina; Departamento de Psicología (S.B.) Universidad de los Andes, Bogotá, Colombia; Department of Cognitive Neurology and Neuropsychology (R.A.), Instituto de Investigaciones Neurológicas "Raúl Carrea" (FLENI) (R.A.), Buenos Aires, Argentina; Universidad de la Costa (CUC) (R.A.), Barranquilla, Colombia; Department of Neurology (R.N.), University of São Paulo Medical School, Brazil; Group of Neuroscience (F.L.), University of Antioquia, Medellín, Colombia; Geroscience Center for Brain Health and Metabolism (A.S.); Physiopathology Department, ICBM, and East Neuroscience Department, Faculty of Medicine (A.S.), and Center for Advanced Research in Education (CIAE) (A.S.), University of Chile; Cognitive Neurology and Dementia, Neurology Department (A.S.), Hospital del Salvador; Neurology Department, Clínica Alemana (A.S.), Santiago, Chile; Research Unit, Peruvian Institute of Neurosciences (N.C., D.L.) and Unit Cognitive Impairment and Dementia Prevention (N.C., D.L.), Lima, Peru; Brain and Mind Centre & School of Psychology (O.P., F.K.), Faculty of Science, University of Sydney; ARC Centre of Excellence in Cognition and its Disorders (O.P., F.K., F.M., A.I.), Sydney, Australia; Fraunhofer Chile (O.P., P.C.), Santiago; and Center for Social and Cognitive Neuroscience (CSCN), School of Psychology (D.H., A.I.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Nilton Custodio
- From the School of Life Sciences (M.A.P.), Psychology, University Heriot-Watt; Human Cognitive Neuroscience (M.A.P.), Psychology, Edinburgh University; Alzheimer's Scotland Dementia Research Centre and Scottish Dementia Clinical Research Network (M.A.P.), Edinburgh; Centre for Cognitive Ageing and Cognitive Epidemiology (M.A.P., T.B.) and Department of Psychology, School of Philosophy, Psychology and Language Sciences (P.C., T.B.), University of Edinburgh, UK; Universidad Autónoma del Caribe (M.A.P., A.I.), Barranquilla, Colombia; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) (S.B., F.M., A.I.); Institute of Translational and Cognitive Neuroscience (INCYT) (S.B., F.M., A.I.), INECO Foundation, Favaloro University, Buenos Aires, Argentina; Departamento de Psicología (S.B.) Universidad de los Andes, Bogotá, Colombia; Department of Cognitive Neurology and Neuropsychology (R.A.), Instituto de Investigaciones Neurológicas "Raúl Carrea" (FLENI) (R.A.), Buenos Aires, Argentina; Universidad de la Costa (CUC) (R.A.), Barranquilla, Colombia; Department of Neurology (R.N.), University of São Paulo Medical School, Brazil; Group of Neuroscience (F.L.), University of Antioquia, Medellín, Colombia; Geroscience Center for Brain Health and Metabolism (A.S.); Physiopathology Department, ICBM, and East Neuroscience Department, Faculty of Medicine (A.S.), and Center for Advanced Research in Education (CIAE) (A.S.), University of Chile; Cognitive Neurology and Dementia, Neurology Department (A.S.), Hospital del Salvador; Neurology Department, Clínica Alemana (A.S.), Santiago, Chile; Research Unit, Peruvian Institute of Neurosciences (N.C., D.L.) and Unit Cognitive Impairment and Dementia Prevention (N.C., D.L.), Lima, Peru; Brain and Mind Centre & School of Psychology (O.P., F.K.), Faculty of Science, University of Sydney; ARC Centre of Excellence in Cognition and its Disorders (O.P., F.K., F.M., A.I.), Sydney, Australia; Fraunhofer Chile (O.P., P.C.), Santiago; and Center for Social and Cognitive Neuroscience (CSCN), School of Psychology (D.H., A.I.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - David Lira
- From the School of Life Sciences (M.A.P.), Psychology, University Heriot-Watt; Human Cognitive Neuroscience (M.A.P.), Psychology, Edinburgh University; Alzheimer's Scotland Dementia Research Centre and Scottish Dementia Clinical Research Network (M.A.P.), Edinburgh; Centre for Cognitive Ageing and Cognitive Epidemiology (M.A.P., T.B.) and Department of Psychology, School of Philosophy, Psychology and Language Sciences (P.C., T.B.), University of Edinburgh, UK; Universidad Autónoma del Caribe (M.A.P., A.I.), Barranquilla, Colombia; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) (S.B., F.M., A.I.); Institute of Translational and Cognitive Neuroscience (INCYT) (S.B., F.M., A.I.), INECO Foundation, Favaloro University, Buenos Aires, Argentina; Departamento de Psicología (S.B.) Universidad de los Andes, Bogotá, Colombia; Department of Cognitive Neurology and Neuropsychology (R.A.), Instituto de Investigaciones Neurológicas "Raúl Carrea" (FLENI) (R.A.), Buenos Aires, Argentina; Universidad de la Costa (CUC) (R.A.), Barranquilla, Colombia; Department of Neurology (R.N.), University of São Paulo Medical School, Brazil; Group of Neuroscience (F.L.), University of Antioquia, Medellín, Colombia; Geroscience Center for Brain Health and Metabolism (A.S.); Physiopathology Department, ICBM, and East Neuroscience Department, Faculty of Medicine (A.S.), and Center for Advanced Research in Education (CIAE) (A.S.), University of Chile; Cognitive Neurology and Dementia, Neurology Department (A.S.), Hospital del Salvador; Neurology Department, Clínica Alemana (A.S.), Santiago, Chile; Research Unit, Peruvian Institute of Neurosciences (N.C., D.L.) and Unit Cognitive Impairment and Dementia Prevention (N.C., D.L.), Lima, Peru; Brain and Mind Centre & School of Psychology (O.P., F.K.), Faculty of Science, University of Sydney; ARC Centre of Excellence in Cognition and its Disorders (O.P., F.K., F.M., A.I.), Sydney, Australia; Fraunhofer Chile (O.P., P.C.), Santiago; and Center for Social and Cognitive Neuroscience (CSCN), School of Psychology (D.H., A.I.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Olivier Piguet
- From the School of Life Sciences (M.A.P.), Psychology, University Heriot-Watt; Human Cognitive Neuroscience (M.A.P.), Psychology, Edinburgh University; Alzheimer's Scotland Dementia Research Centre and Scottish Dementia Clinical Research Network (M.A.P.), Edinburgh; Centre for Cognitive Ageing and Cognitive Epidemiology (M.A.P., T.B.) and Department of Psychology, School of Philosophy, Psychology and Language Sciences (P.C., T.B.), University of Edinburgh, UK; Universidad Autónoma del Caribe (M.A.P., A.I.), Barranquilla, Colombia; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) (S.B., F.M., A.I.); Institute of Translational and Cognitive Neuroscience (INCYT) (S.B., F.M., A.I.), INECO Foundation, Favaloro University, Buenos Aires, Argentina; Departamento de Psicología (S.B.) Universidad de los Andes, Bogotá, Colombia; Department of Cognitive Neurology and Neuropsychology (R.A.), Instituto de Investigaciones Neurológicas "Raúl Carrea" (FLENI) (R.A.), Buenos Aires, Argentina; Universidad de la Costa (CUC) (R.A.), Barranquilla, Colombia; Department of Neurology (R.N.), University of São Paulo Medical School, Brazil; Group of Neuroscience (F.L.), University of Antioquia, Medellín, Colombia; Geroscience Center for Brain Health and Metabolism (A.S.); Physiopathology Department, ICBM, and East Neuroscience Department, Faculty of Medicine (A.S.), and Center for Advanced Research in Education (CIAE) (A.S.), University of Chile; Cognitive Neurology and Dementia, Neurology Department (A.S.), Hospital del Salvador; Neurology Department, Clínica Alemana (A.S.), Santiago, Chile; Research Unit, Peruvian Institute of Neurosciences (N.C., D.L.) and Unit Cognitive Impairment and Dementia Prevention (N.C., D.L.), Lima, Peru; Brain and Mind Centre & School of Psychology (O.P., F.K.), Faculty of Science, University of Sydney; ARC Centre of Excellence in Cognition and its Disorders (O.P., F.K., F.M., A.I.), Sydney, Australia; Fraunhofer Chile (O.P., P.C.), Santiago; and Center for Social and Cognitive Neuroscience (CSCN), School of Psychology (D.H., A.I.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Fiona Kumfor
- From the School of Life Sciences (M.A.P.), Psychology, University Heriot-Watt; Human Cognitive Neuroscience (M.A.P.), Psychology, Edinburgh University; Alzheimer's Scotland Dementia Research Centre and Scottish Dementia Clinical Research Network (M.A.P.), Edinburgh; Centre for Cognitive Ageing and Cognitive Epidemiology (M.A.P., T.B.) and Department of Psychology, School of Philosophy, Psychology and Language Sciences (P.C., T.B.), University of Edinburgh, UK; Universidad Autónoma del Caribe (M.A.P., A.I.), Barranquilla, Colombia; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) (S.B., F.M., A.I.); Institute of Translational and Cognitive Neuroscience (INCYT) (S.B., F.M., A.I.), INECO Foundation, Favaloro University, Buenos Aires, Argentina; Departamento de Psicología (S.B.) Universidad de los Andes, Bogotá, Colombia; Department of Cognitive Neurology and Neuropsychology (R.A.), Instituto de Investigaciones Neurológicas "Raúl Carrea" (FLENI) (R.A.), Buenos Aires, Argentina; Universidad de la Costa (CUC) (R.A.), Barranquilla, Colombia; Department of Neurology (R.N.), University of São Paulo Medical School, Brazil; Group of Neuroscience (F.L.), University of Antioquia, Medellín, Colombia; Geroscience Center for Brain Health and Metabolism (A.S.); Physiopathology Department, ICBM, and East Neuroscience Department, Faculty of Medicine (A.S.), and Center for Advanced Research in Education (CIAE) (A.S.), University of Chile; Cognitive Neurology and Dementia, Neurology Department (A.S.), Hospital del Salvador; Neurology Department, Clínica Alemana (A.S.), Santiago, Chile; Research Unit, Peruvian Institute of Neurosciences (N.C., D.L.) and Unit Cognitive Impairment and Dementia Prevention (N.C., D.L.), Lima, Peru; Brain and Mind Centre & School of Psychology (O.P., F.K.), Faculty of Science, University of Sydney; ARC Centre of Excellence in Cognition and its Disorders (O.P., F.K., F.M., A.I.), Sydney, Australia; Fraunhofer Chile (O.P., P.C.), Santiago; and Center for Social and Cognitive Neuroscience (CSCN), School of Psychology (D.H., A.I.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - David Huepe
- From the School of Life Sciences (M.A.P.), Psychology, University Heriot-Watt; Human Cognitive Neuroscience (M.A.P.), Psychology, Edinburgh University; Alzheimer's Scotland Dementia Research Centre and Scottish Dementia Clinical Research Network (M.A.P.), Edinburgh; Centre for Cognitive Ageing and Cognitive Epidemiology (M.A.P., T.B.) and Department of Psychology, School of Philosophy, Psychology and Language Sciences (P.C., T.B.), University of Edinburgh, UK; Universidad Autónoma del Caribe (M.A.P., A.I.), Barranquilla, Colombia; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) (S.B., F.M., A.I.); Institute of Translational and Cognitive Neuroscience (INCYT) (S.B., F.M., A.I.), INECO Foundation, Favaloro University, Buenos Aires, Argentina; Departamento de Psicología (S.B.) Universidad de los Andes, Bogotá, Colombia; Department of Cognitive Neurology and Neuropsychology (R.A.), Instituto de Investigaciones Neurológicas "Raúl Carrea" (FLENI) (R.A.), Buenos Aires, Argentina; Universidad de la Costa (CUC) (R.A.), Barranquilla, Colombia; Department of Neurology (R.N.), University of São Paulo Medical School, Brazil; Group of Neuroscience (F.L.), University of Antioquia, Medellín, Colombia; Geroscience Center for Brain Health and Metabolism (A.S.); Physiopathology Department, ICBM, and East Neuroscience Department, Faculty of Medicine (A.S.), and Center for Advanced Research in Education (CIAE) (A.S.), University of Chile; Cognitive Neurology and Dementia, Neurology Department (A.S.), Hospital del Salvador; Neurology Department, Clínica Alemana (A.S.), Santiago, Chile; Research Unit, Peruvian Institute of Neurosciences (N.C., D.L.) and Unit Cognitive Impairment and Dementia Prevention (N.C., D.L.), Lima, Peru; Brain and Mind Centre & School of Psychology (O.P., F.K.), Faculty of Science, University of Sydney; ARC Centre of Excellence in Cognition and its Disorders (O.P., F.K., F.M., A.I.), Sydney, Australia; Fraunhofer Chile (O.P., P.C.), Santiago; and Center for Social and Cognitive Neuroscience (CSCN), School of Psychology (D.H., A.I.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Patricia Cogram
- From the School of Life Sciences (M.A.P.), Psychology, University Heriot-Watt; Human Cognitive Neuroscience (M.A.P.), Psychology, Edinburgh University; Alzheimer's Scotland Dementia Research Centre and Scottish Dementia Clinical Research Network (M.A.P.), Edinburgh; Centre for Cognitive Ageing and Cognitive Epidemiology (M.A.P., T.B.) and Department of Psychology, School of Philosophy, Psychology and Language Sciences (P.C., T.B.), University of Edinburgh, UK; Universidad Autónoma del Caribe (M.A.P., A.I.), Barranquilla, Colombia; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) (S.B., F.M., A.I.); Institute of Translational and Cognitive Neuroscience (INCYT) (S.B., F.M., A.I.), INECO Foundation, Favaloro University, Buenos Aires, Argentina; Departamento de Psicología (S.B.) Universidad de los Andes, Bogotá, Colombia; Department of Cognitive Neurology and Neuropsychology (R.A.), Instituto de Investigaciones Neurológicas "Raúl Carrea" (FLENI) (R.A.), Buenos Aires, Argentina; Universidad de la Costa (CUC) (R.A.), Barranquilla, Colombia; Department of Neurology (R.N.), University of São Paulo Medical School, Brazil; Group of Neuroscience (F.L.), University of Antioquia, Medellín, Colombia; Geroscience Center for Brain Health and Metabolism (A.S.); Physiopathology Department, ICBM, and East Neuroscience Department, Faculty of Medicine (A.S.), and Center for Advanced Research in Education (CIAE) (A.S.), University of Chile; Cognitive Neurology and Dementia, Neurology Department (A.S.), Hospital del Salvador; Neurology Department, Clínica Alemana (A.S.), Santiago, Chile; Research Unit, Peruvian Institute of Neurosciences (N.C., D.L.) and Unit Cognitive Impairment and Dementia Prevention (N.C., D.L.), Lima, Peru; Brain and Mind Centre & School of Psychology (O.P., F.K.), Faculty of Science, University of Sydney; ARC Centre of Excellence in Cognition and its Disorders (O.P., F.K., F.M., A.I.), Sydney, Australia; Fraunhofer Chile (O.P., P.C.), Santiago; and Center for Social and Cognitive Neuroscience (CSCN), School of Psychology (D.H., A.I.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Thomas Bak
- From the School of Life Sciences (M.A.P.), Psychology, University Heriot-Watt; Human Cognitive Neuroscience (M.A.P.), Psychology, Edinburgh University; Alzheimer's Scotland Dementia Research Centre and Scottish Dementia Clinical Research Network (M.A.P.), Edinburgh; Centre for Cognitive Ageing and Cognitive Epidemiology (M.A.P., T.B.) and Department of Psychology, School of Philosophy, Psychology and Language Sciences (P.C., T.B.), University of Edinburgh, UK; Universidad Autónoma del Caribe (M.A.P., A.I.), Barranquilla, Colombia; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) (S.B., F.M., A.I.); Institute of Translational and Cognitive Neuroscience (INCYT) (S.B., F.M., A.I.), INECO Foundation, Favaloro University, Buenos Aires, Argentina; Departamento de Psicología (S.B.) Universidad de los Andes, Bogotá, Colombia; Department of Cognitive Neurology and Neuropsychology (R.A.), Instituto de Investigaciones Neurológicas "Raúl Carrea" (FLENI) (R.A.), Buenos Aires, Argentina; Universidad de la Costa (CUC) (R.A.), Barranquilla, Colombia; Department of Neurology (R.N.), University of São Paulo Medical School, Brazil; Group of Neuroscience (F.L.), University of Antioquia, Medellín, Colombia; Geroscience Center for Brain Health and Metabolism (A.S.); Physiopathology Department, ICBM, and East Neuroscience Department, Faculty of Medicine (A.S.), and Center for Advanced Research in Education (CIAE) (A.S.), University of Chile; Cognitive Neurology and Dementia, Neurology Department (A.S.), Hospital del Salvador; Neurology Department, Clínica Alemana (A.S.), Santiago, Chile; Research Unit, Peruvian Institute of Neurosciences (N.C., D.L.) and Unit Cognitive Impairment and Dementia Prevention (N.C., D.L.), Lima, Peru; Brain and Mind Centre & School of Psychology (O.P., F.K.), Faculty of Science, University of Sydney; ARC Centre of Excellence in Cognition and its Disorders (O.P., F.K., F.M., A.I.), Sydney, Australia; Fraunhofer Chile (O.P., P.C.), Santiago; and Center for Social and Cognitive Neuroscience (CSCN), School of Psychology (D.H., A.I.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Facundo Manes
- From the School of Life Sciences (M.A.P.), Psychology, University Heriot-Watt; Human Cognitive Neuroscience (M.A.P.), Psychology, Edinburgh University; Alzheimer's Scotland Dementia Research Centre and Scottish Dementia Clinical Research Network (M.A.P.), Edinburgh; Centre for Cognitive Ageing and Cognitive Epidemiology (M.A.P., T.B.) and Department of Psychology, School of Philosophy, Psychology and Language Sciences (P.C., T.B.), University of Edinburgh, UK; Universidad Autónoma del Caribe (M.A.P., A.I.), Barranquilla, Colombia; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) (S.B., F.M., A.I.); Institute of Translational and Cognitive Neuroscience (INCYT) (S.B., F.M., A.I.), INECO Foundation, Favaloro University, Buenos Aires, Argentina; Departamento de Psicología (S.B.) Universidad de los Andes, Bogotá, Colombia; Department of Cognitive Neurology and Neuropsychology (R.A.), Instituto de Investigaciones Neurológicas "Raúl Carrea" (FLENI) (R.A.), Buenos Aires, Argentina; Universidad de la Costa (CUC) (R.A.), Barranquilla, Colombia; Department of Neurology (R.N.), University of São Paulo Medical School, Brazil; Group of Neuroscience (F.L.), University of Antioquia, Medellín, Colombia; Geroscience Center for Brain Health and Metabolism (A.S.); Physiopathology Department, ICBM, and East Neuroscience Department, Faculty of Medicine (A.S.), and Center for Advanced Research in Education (CIAE) (A.S.), University of Chile; Cognitive Neurology and Dementia, Neurology Department (A.S.), Hospital del Salvador; Neurology Department, Clínica Alemana (A.S.), Santiago, Chile; Research Unit, Peruvian Institute of Neurosciences (N.C., D.L.) and Unit Cognitive Impairment and Dementia Prevention (N.C., D.L.), Lima, Peru; Brain and Mind Centre & School of Psychology (O.P., F.K.), Faculty of Science, University of Sydney; ARC Centre of Excellence in Cognition and its Disorders (O.P., F.K., F.M., A.I.), Sydney, Australia; Fraunhofer Chile (O.P., P.C.), Santiago; and Center for Social and Cognitive Neuroscience (CSCN), School of Psychology (D.H., A.I.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Agustin Ibanez
- From the School of Life Sciences (M.A.P.), Psychology, University Heriot-Watt; Human Cognitive Neuroscience (M.A.P.), Psychology, Edinburgh University; Alzheimer's Scotland Dementia Research Centre and Scottish Dementia Clinical Research Network (M.A.P.), Edinburgh; Centre for Cognitive Ageing and Cognitive Epidemiology (M.A.P., T.B.) and Department of Psychology, School of Philosophy, Psychology and Language Sciences (P.C., T.B.), University of Edinburgh, UK; Universidad Autónoma del Caribe (M.A.P., A.I.), Barranquilla, Colombia; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) (S.B., F.M., A.I.); Institute of Translational and Cognitive Neuroscience (INCYT) (S.B., F.M., A.I.), INECO Foundation, Favaloro University, Buenos Aires, Argentina; Departamento de Psicología (S.B.) Universidad de los Andes, Bogotá, Colombia; Department of Cognitive Neurology and Neuropsychology (R.A.), Instituto de Investigaciones Neurológicas "Raúl Carrea" (FLENI) (R.A.), Buenos Aires, Argentina; Universidad de la Costa (CUC) (R.A.), Barranquilla, Colombia; Department of Neurology (R.N.), University of São Paulo Medical School, Brazil; Group of Neuroscience (F.L.), University of Antioquia, Medellín, Colombia; Geroscience Center for Brain Health and Metabolism (A.S.); Physiopathology Department, ICBM, and East Neuroscience Department, Faculty of Medicine (A.S.), and Center for Advanced Research in Education (CIAE) (A.S.), University of Chile; Cognitive Neurology and Dementia, Neurology Department (A.S.), Hospital del Salvador; Neurology Department, Clínica Alemana (A.S.), Santiago, Chile; Research Unit, Peruvian Institute of Neurosciences (N.C., D.L.) and Unit Cognitive Impairment and Dementia Prevention (N.C., D.L.), Lima, Peru; Brain and Mind Centre & School of Psychology (O.P., F.K.), Faculty of Science, University of Sydney; ARC Centre of Excellence in Cognition and its Disorders (O.P., F.K., F.M., A.I.), Sydney, Australia; Fraunhofer Chile (O.P., P.C.), Santiago; and Center for Social and Cognitive Neuroscience (CSCN), School of Psychology (D.H., A.I.), Universidad Adolfo Ibáñez, Santiago, Chile.
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Association between the APOE ε4 Allele and Late-Onset Alzheimer's Disease in an Ecuadorian Mestizo Population. Int J Alzheimers Dis 2017; 2017:1059678. [PMID: 29348964 PMCID: PMC5733981 DOI: 10.1155/2017/1059678] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 09/27/2017] [Accepted: 10/26/2017] [Indexed: 12/30/2022] Open
Abstract
Alzheimer's disease (AD) is the most common neurodegenerative disease. It has two main pathological hallmarks: amyloid plaques and neurofibrillary tangles. The APOE ε4 allele has been recognized as the strongest genetic risk factor for late-onset Alzheimer's disease (LOAD) in several populations worldwide, yet the risk varies by region and ethnicity. The aims of this study were to describe APOE allele and genotype frequencies and examine the relationship between the APOE ε4 allele and LOAD risk in an Ecuadorian Mestizo population. We carried out a case-control study comprising 56 individuals clinically diagnosed with probable AD (≥65 years of age) and 58 unrelated healthy control subjects (≥65 years of age). Genotyping was performed using the real-time PCR method. Our data showed that allelic and genotypic frequencies follow the trends observed in most worldwide populations. We also found a high-risk association between APOE ε4 allele carriers and LOAD (OR = 7.286; 95% CI = 2.824–18.799; p < 0.001). Therefore, we concluded that APOE ε4 must be considered an important genetic risk factor for LOAD in the Ecuadorian Mestizo population. Additionally, we suggest that in mixed populations the effects of admixture and ethnic identity should be differentiated when evaluating genetic contributions to Alzheimer's disease risk.
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Custodio N, Wheelock A, Thumala D, Slachevsky A. Dementia in Latin America: Epidemiological Evidence and Implications for Public Policy. Front Aging Neurosci 2017; 9:221. [PMID: 28751861 PMCID: PMC5508025 DOI: 10.3389/fnagi.2017.00221] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 06/23/2017] [Indexed: 01/20/2023] Open
Abstract
Population aging is among the most important global transformations. Today, 12% of the world population is of age 60 and over and by the middle of this century this segment will represent 21.5%. The increase in population of those aged 80 and over, also referred to as the "oldest old" or the "very elderly", will be even more pronounced, going from 1.7% of the population to 4.5% within the same period. Compared to European and North American countries, Latin America (LA) is experiencing this unprecedented demographic change at a significantly faster rate. Due to demographic and health transitions, the number of people with dementia will rise from 7.8 million in 2013 to over 27 million by 2050. Nowadays, the global prevalence of dementia in LA has reached 7.1%, with Alzheimer's Disease (AD) being the most frequent type. This level is similar to those found in developed countries; however, the dementia rate is twice as high as that of the 65-69 years age group in developed countries. In addition, the prevalence and incidence of dementia is higher among illiterate people. Mortality rates due to dementia have risen considerably. The burden and costs of the disease are high and must be covered by patients' families. The prevention of dementia and the development of long-term care policies and plans for people with dementia in LA, which take into account regional differences and similarities, should be urgent priorities.
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Affiliation(s)
- Nilton Custodio
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Departamento de Neurología, Instituto Peruano de NeurocienciasLima, Peru
| | - Ana Wheelock
- Gerosciences Center for Brain Health and Metabolism (GERO)Santiago, Chile.,Department of Surgery and Cancer, National Institute for Health Research Imperial Patient Safety Translational Research Centre, Imperial College LondonLondon, United Kingdom
| | - Daniela Thumala
- Gerosciences Center for Brain Health and Metabolism (GERO)Santiago, Chile.,Psychology Department, Faculty of Social Sciences, Universidad de ChileSantiago, Chile
| | - Andrea Slachevsky
- Gerosciences Center for Brain Health and Metabolism (GERO)Santiago, Chile.,Physiopathology Department, ICBM, and East Neuroscience Department, Faculty of Medicine, Universidad de ChileSantiago, Chile.,Cognitive Neurology and Dementia Unit, Neurology Department, Hospital del SalvadorSantiago, Chile.,Center for Advanced Research in Education (CIAE), Universidad de ChileSantiago, Chile.,Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del DesarrolloSantiago, Chile
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