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Jeyagurunathan A, Yuan Q, Samari E, Zhang Y, Goveas R, Ng LL, Subramaniam M. Facilitators and barriers of help-seeking for persons with dementia in Asia-findings from a qualitative study of informal caregivers. Front Public Health 2024; 12:1396056. [PMID: 39071142 PMCID: PMC11282579 DOI: 10.3389/fpubh.2024.1396056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 06/24/2024] [Indexed: 07/30/2024] Open
Abstract
Background and aim The deterioration in cognition of persons with dementia (PWD) makes their caregivers key players in their help-seeking process. This study aimed to identify the facilitators and barriers of help-seeking for persons with dementia in Asia from the perspective of their informal caregivers. Methods A qualitative methodology was adopted in the current study. Twenty-nine informal caregivers of PWD in Singapore were interviewed between April 2019 and December 2020. All interviews were audio-recorded and transcribed verbatim for the analysis. Results The transcripts were analyzed using inductive thematic analysis. The results revealed four major themes with 12 sub-themes, including (1) Barriers to diagnosis-seeking (i.e., lack of knowledge and awareness of dementia, emotional denial, resistance from PWD, and delays in the healthcare system); (2) Facilitators of diagnosis-seeking (i.e., synergy between awareness of dementia and an active diagnosis-seeking intention and incidental diagnosis resulting from seeking treatment for comorbid conditions); (3) Barriers to treatment-seeking (i.e., challenges from PWD and disease, challenges faced by caregivers when seeking treatment for PWD, and challenges imposed by the COVID-19 pandemic); (4) Facilitators of treatment-seeking (i.e., caregivers' capabilities of handling PWD, cooperation/compliance from PWD, and an integrated care plan for PWD). Conclusion The findings highlight the importance of raising public awareness, enabling health professionals to tailor psychosocial interventions better, and improving community support through dementia awareness and education.
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Affiliation(s)
| | - Qi Yuan
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Ellaisha Samari
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Yunjue Zhang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Richard Goveas
- Department of Geriatric Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Li Ling Ng
- Department of Psychological Medicine, Changi General Hospital, Singapore, Singapore
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Ruppert EP, Rocha JVDF, da Silva AL, Tomaz KLDS, Friedlaender CV, Assenção JDCM, Rincon LP, Ribeiro NGF, Santos DCDS, Lima APZ, Allen IE, Caramelli P, Grinberg LT, Maciel FIP, Resende EDPF. Episodic memory improvement in illiterate adults attending late-life education irrespective of low socioeconomic status: insights from the PROAME study. Dement Neuropsychol 2024; 18:e20230098. [PMID: 38957727 PMCID: PMC11218930 DOI: 10.1590/1980-5764-dn-2023-0098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 01/29/2024] [Accepted: 03/03/2024] [Indexed: 07/04/2024] Open
Abstract
The majority of people with dementia live in low or middle-income countries (LMICs) where resources that play a crucial role in brain health, such as quality education, are still not widely available. In Brazil, illiteracy remains a prevalent issue, especially in communities with lower socioeconomic status (SES). The PROAME study set out to explore basic education in illiterate adults as a means to improve cognitive reserve. Objective This manuscript aims to explore the relationship between SES and learning, as well as cognitive outcomes, in an older illiterate population. Methods This six-month clinical trial (NCT04473235) involved 108 participants, of which 77 concluded all assessments, enrolled in late-life basic education. SES assessments included Quality of Urban Living Index, Municipal Human Development Index and Household SES calculated for each participant. Cognitive assessments encompassed the Free and Cued Selective Reminding Test (FCSRT), a word list to assess reading, and the Beta III matrix. Results The sample consisted primarily of women, with a mean age of 58.5. Participants improved their reading (p=0.01) and their FCSRT (p=0.003). Regarding episodic memory, women outperformed men (p=0.007) and younger participants improved more than their older counterparts (p=0.001). There was no association observed between SES and cognitive outcomes. Conclusion Irrespective of SES, participants demonstrated positive outcomes after attending basic education. These findings highlight that late life education could be an important non-pharmacologic preventative measure, especially in LMICs.
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Affiliation(s)
- Emma Patrice Ruppert
- Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte MG, Brazil
- University of Pittsburgh, Pascoal Lab, Pittsburgh PA, USA
| | - João Victor de Faria Rocha
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Grupo de Pesquisa Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brazil
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Belo Horizonte MG, Brazil
| | | | - Kelle Luisa Dos Santos Tomaz
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Grupo de Pesquisa Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brazil
| | - Clarisse Vasconcelos Friedlaender
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Grupo de Pesquisa Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brazil
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Belo Horizonte MG, Brazil
| | - Joanna de Castro Magalhães Assenção
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Grupo de Pesquisa Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brazil
| | - Luciana Paula Rincon
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Grupo de Pesquisa Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brazil
| | - Norton Gray Ferreira Ribeiro
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Grupo de Pesquisa Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brazil
| | | | | | - Isabel Elaine Allen
- University of California San Francisco, Global Brain Health Institute, San Francisco CA, USA
| | - Paulo Caramelli
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Grupo de Pesquisa Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brazil
| | - Lea Tenenholz Grinberg
- University of California San Francisco, Global Brain Health Institute, San Francisco CA, USA
- University of California, Memory and Aging Center, UCSF Weill Institute for Neurosciences, San Francisco CA, USA
| | - Francisca Izabel Pereira Maciel
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Grupo de Pesquisa Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brazil
| | - Elisa de Paula França Resende
- Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte MG, Brazil
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Grupo de Pesquisa Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brazil
- University of California San Francisco, Global Brain Health Institute, San Francisco CA, USA
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Calandri IL, Livingston G, Paradela R, Ossenkoppele R, Crivelli L, Allegri RF, Suemoto CK. Sex and Socioeconomic Disparities in Dementia Risk: A Population-Attributable Fraction Analysis in Argentina. Neuroepidemiology 2024; 58:264-275. [PMID: 38295775 PMCID: PMC11302740 DOI: 10.1159/000536524] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 01/09/2024] [Indexed: 08/07/2024] Open
Abstract
INTRODUCTION Twelve modifiable risk factors (RFs) account for 40% of dementia cases worldwide. However, limited data exist on such factors in middle- and low-income countries. We aimed to estimate the population-attributable fractions (PAFs) for the 12 RFs in Argentina, assessing changes over a decade and exploring socioeconomic and sex influences. METHODS We conducted cross-sectional analyses of the 12 RFs from Argentinian surveys conducted in 2009, 2015, and 2018, including 96,321 people. We calculated PAFs and stratified estimates based on sex and income. RESULTS We estimated an overall PAF of 59.6% (95% CI = 58.9-60.3%). The largest PAFs were hypertension = 9.3% (8.7-9.9%), physical inactivity = 7.4% (6.8-8.2%), and obesity = 7.4% (6.8-7.9%). Men were more impacted by excessive alcohol, while women by isolation and smoking. Lower income linked to higher PAFs in education, hypertension, and obesity. DISCUSSION Argentina has a higher PAF for dementia than the world population, with distinct RF distribution. PAF varied by sex and economic status, advocating tailored prevention strategies.
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Affiliation(s)
- Ismael Luis Calandri
- Department of Cognitive Neurology, Fleni, Buenos Aires, Argentina
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Gill Livingston
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Regina Paradela
- Discipline of Geriatrics, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Rik Ossenkoppele
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Lucia Crivelli
- Department of Cognitive Neurology, Fleni, Buenos Aires, Argentina
| | - Ricardo F. Allegri
- Department of Cognitive Neurology, Fleni, Buenos Aires, Argentina
- Departamento de Ciencias de la Salud, Universidad de la Costa, Barranquilla, Colombia
| | - Claudia K. Suemoto
- Discipline of Geriatrics, University of Sao Paulo Medical School, Sao Paulo, Brazil
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Daniel EV, Wiese LAK, Holt JK. Assessing Alzheimer's Disease Knowledge and Cognitive Risk Among a Rural Older Afro-Caribbean Cohort. J Community Health Nurs 2024; 41:1-10. [PMID: 37705286 PMCID: PMC10841183 DOI: 10.1080/07370016.2023.2257199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
PURPOSE Older, rural Afro-Caribbeans are a growing subset of the Black population who face increased risk for Alzheimer's disease and related dementias (ADRD), but research targeting ADRD is scarce in this group. The purpose of this study was to investigate dementia risk among older Afro-Caribbeans living in a rural area. We also examined age, sex, and years of education, and knowledge about Alzheimer's disease as potential predictors of dementia risk. DESIGN A pre-post, correlational design was employed. METHODS Cognitive screenings were conducted using Nasreddine's Mini-MoCA, with tests of language fluency/orientation/recall, and linear regression analysis. A basic knowledge of Alzheimer's disease survey (BKAD) was also administered. FINDINGS A total of 55 Afro-Caribbean participants (67.0 +10.8y (M ± SD), 65.5% with 10y or less of education residing in a rural area within the last 20 years were included.Over 50% of the convenience sample scored in the cognitive risk range. Significant associations were found between Mini-MoCA Total and Language scores and education (p < 0.01). Further, there was a significant change from pretest to posttest in BKAD scores. BKAD pretest and posttest scores were also significantly higher for those without dementia risk based on the Mini-MoCA Total. CONCLUSION While the Mini-MoCA showed good reliability in less-educated older Afro-Caribbeans, scores were strongly dependent on years of education. Offering a limited intervention resulted in increased BKAD scores in this Afro-Caribbean sample, and a low BKAD score was associated with a higher dementia risk category. CLINICAL EVIDENCE This study contributes to the limited but growing body of research about Alzheimer's disease knowledge, cognitive risk, and dementia detection among Afro-Caribbeans. The use of language-neutral cognitive assessments is recommended among rural older immigrants.
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Affiliation(s)
- E Valerie Daniel
- Comprehensive Center for Brain Health, University of Miami, Miller School of Medicine, Boca Raton, Florida, USA
| | - Lisa Ann Kirk Wiese
- C. E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, Florida, USA
| | - Janet K Holt
- Academic Researcher, Southern Illinois University Edwardsville, C. E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, Florida, USA
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Fox S, León T, Mariano L, Arshad F, Magrath Guimet N, Hope G, Tituaña K, Zapata-Restrepo LM. Perspectives on brain health and dementia prevention in Latin America: challenges and opportunities. FRONTIERS IN DEMENTIA 2023; 2:1275641. [PMID: 39081987 PMCID: PMC11285633 DOI: 10.3389/frdem.2023.1275641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 09/11/2023] [Indexed: 08/02/2024]
Abstract
While age-specific dementia prevalence is falling in many countries, several recent reviews estimate prevalence in Latin America to be higher than anywhere else in the world. This may be, in part, due to the high incidence of socioeconomic and health-related risk factors present in the region. However, growing evidence suggests that primary and secondary prevention via modifiable risk factors is possible, and that 40% of cases may be mitigated through interventions which target modifiable risk. This suggests that there may be significant scope for dementia risk reduction in this region. In June 2021, eight fellows from the Global Brain Health Institute (GBHI) hosted an expert consensus workshop on challenges and opportunities for brain health and dementia prevention in Latin America. The workshop brought together 16 experts in dementia, aging, and brain health from a range of professional backgrounds and geographical regions. From this workshop we collated an expert-led consensus regarding the practical challenges and opportunities implicit in embedding brain health and dementia prevention initiatives in the Latin American context. Here we discuss the outcomes of this workshop, highlighting several challenges and opportunities and discussing how these may be addressed.
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Affiliation(s)
- Sarah Fox
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, National Institute for Health and Care Research (NIHR) Applied Research Collaboration Greater Manchester (ARC-GM), Manchester, United Kingdom
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Tomás León
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
- Neurology Department, Memory and Neuropsychiatric Center, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
| | - Luciano Mariano
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Faheem Arshad
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
| | - Nahuel Magrath Guimet
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
- Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría, Neurology Department, Fleni, Buenos Aires, Argentina
| | - Grainne Hope
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Kuripacha Tituaña
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
- Technical and Technological Training Unit, Pontificia Universidad Católica del Ecuador Ibarra, Quito, Ecuador
| | - Lina María Zapata-Restrepo
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
- Department of Internal Medicine, Fundación Valle del Lili, Cali, Colombia
- Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
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Ramos‐Henderson M, Soto‐Añari M, Herrera‐Pino J, Porto MF, Camargo L, Hesse H, Ferrel‐Ortega † R, Quispe‐Ayala C, García de la Cadena C, Mendoza‐Ruvalcaba N, Caldichoury N, Castellanos C, Varón C, Aguilar D, Antezana R, Martinez J, Román N, Boza C, Ducassou A, Saldías C, López N. Factors associated with cognitive impairment in Latin American older adults: A cross-sectional observational study of COVID-19 confinement. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12427. [PMID: 37063389 PMCID: PMC10102893 DOI: 10.1002/dad2.12427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 02/10/2023] [Accepted: 03/12/2023] [Indexed: 04/18/2023]
Abstract
INTRODUCTION The effects of COVID-19 confinement have been severe, especially in older adults. Therefore, we analyzed the factors associated with cognitive impairment (CI) in Latin America (LA). METHODS We conducted a cross-sectional observational study with a total of 5245 older adults from 10 countries in LA. Measurement We used the Telephone Montreal Cognitive Assessment (T-MoCA) and the Eight-item Informant Interview to Differentiate Aging and Dementia (AD8) scale. RESULTS We found that age, depressive symptomatology, bone fractures, being widowed, having a family member with dementia, and unemployment were associated with an increased risk of CI. In contrast, higher education, hypertension with continuous treatment, quarantine, and keeping stimulating cognitive and physical activities were associated with a lower probability of CI. No significant association was found between suffering from diabetes or being retired and CI. DISCUSSION It is essential to conduct follow-up studies on these factors, considering their relationship with CI and the duration of confinement.
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Affiliation(s)
- Miguel Ramos‐Henderson
- Centro de Investigación e Innovación en Gerontología Aplicada (CIGAP)Facultad de SaludUniversidad Santo TomásAntofagastaChile
| | - Marcio Soto‐Añari
- Departamento de PsicologíaUniversidad Católica San PabloArequipaPerú
| | | | - María F. Porto
- Neuroscience AreaL'Institut d'Investigació Biomèdica de Bellvitge (IDIBELL)BarcelonaSpain
- Department of CognitionDevelopment and Educational PsychologyUniversitat de BarcelonaBarcelonaSpain
| | - Loida Camargo
- Facultad de Medicina, Departamento Médico, Grupo de investigación Neurociencia y Salud GlobalUniversidad de CartagenaCartagena de IndiasColombia
| | - Heike Hesse
- Observatorio COVID‐19Universidad Tecnológica CentroamericanaTegucigalpaHonduras
| | - Robert Ferrel‐Ortega †
- Programa de PsicologíaFacultad de Ciencias de la SaludUniversidad MagdalenaSanta MartaColombia
| | - Cesar Quispe‐Ayala
- Facultad de Derecho y Ciencias PolíticasUniversidad Nacional de HuancavelicaHuancavelicaPerú
| | - Claudia García de la Cadena
- Departamento de NeuropsicologíaFacultad de Ciencias SocialesUniversidad del Valle de GuatemalaGuatemala CityGuatema
| | - Neyda Mendoza‐Ruvalcaba
- Departamento de Ciencias de la Salud Enfermedad como Proceso IndividualUniversidad de GuadalajaraCutonalaMéxico
| | | | - Cesar Castellanos
- Dirección ejecutivaInstituto Dominicano para el Estudio de la Salud Integral y la Psicología Aplicada (IDESIP)Santo DomingoRepública Dominicana
| | - Claudia Varón
- Dirección ejecutivaFundación Acción Familiar Alzheimer Colombia‐AFACOLBogotáColombia
| | - Dolores Aguilar
- Facultad de Derecho y Ciencias PolíticasUniversidad Nacional de HuancavelicaHuancavelicaPerú
| | - Regulo Antezana
- Facultad de Derecho y Ciencias PolíticasUniversidad Nacional de HuancavelicaHuancavelicaPerú
| | - Juan Martinez
- Departmet of EducationUniversidad Ana G. MéndezSan JuanPuerto Rico
| | - Norbel Román
- Centro de Investigación en Hematología y Trastornos AfinesUniversidad de Costa RicaSan JoséCosta Rica
| | - Carolina Boza
- Centro de Investigación en Hematología y Trastornos AfinesUniversidad de Costa RicaSan JoséCosta Rica
| | - Alejandro Ducassou
- Vicerrectoría Regional y Escuela de PsicologiaFaculta de Medicina y Ciencias de la SaludUniversidad Mayor‐TemucoTemucoChile
| | - Carol Saldías
- Facultad de Ciencias de la SaludUniversidad San SebastiánValdiviaChile
| | - Norman López
- Departamento de Ciencias SocialesUniversidad de La CostaBarranquillaColombia
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Pelegrini LNDC, Casemiro FG, Bregola A, Ottaviani AC, Pavarini SCI. Performance of older adults in a digital change detection task: The role of heterogeneous education. APPLIED NEUROPSYCHOLOGY: ADULT 2023:1-9. [DOI: 10.1080/23279095.2023.2189520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
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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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9
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Gajardo J, Alvarado R, Slachevsky A, Gitlin LN. Self-stigma in people living with dementia in Chile: A qualitative exploratory study. Aging Ment Health 2022; 26:2481-2488. [PMID: 34772289 DOI: 10.1080/13607863.2021.1998351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Self-stigma is a dimension of stigma concerning how individuals internalize negative attributes and discriminate against their own selves. Dementia is a stigmatizing condition, and there is a paucity of research exploring the manifestations and implications of self- stigma in people living with dementia in various contexts. AIM To examine how self-stigma manifests in the experiences of people living with early-stage dementia in Santiago, Chile. PARTICIPANTS Six men and five women living with early-stage dementia of the Alzheimer's type, aged between 64 and 82 years old (mean = 70). METHODS One-on-one interviews were conducted, focusing on the experience of people living with early-stage dementia to provide insights on how self-stigma manifests. Interviews were analyzed with a qualitative content analysis approach using Corrigan's social cognitive model of self-stigma (2016). RESULTS Self-stigma manifested as devaluation and blame at a cognitive level, and as restriction of participation at a behavioral level. Families and dementia education emerged as contextual elements that influenced the internalization of negative attributes in the participants' experiences. CONCLUSIONS Consistent with previous qualitative research, we found that self-stigma has negative consequences as it concerns emotions, self-prejudices, and self-discrimination. This study provides distinctive insights on the process of internalization of stigma and the influence of external elements. Self-stigma remains an understudied but important feature of the dementia experience, an understanding of which can lead to developing and testing supportive approaches upon diagnosis to minimize its adverse effects.
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Affiliation(s)
- Jean Gajardo
- Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebastián, Santiago, Chile.,Department of Occupational Therapy and Occupational Science, University of Chile, Santiago, Chile
| | - Rubén Alvarado
- School of Public Health, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Andrea Slachevsky
- Geroscience Center for Brain Health and Metabolism (GERO), 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.,Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
| | - Laura N Gitlin
- College of Nursing and Health Professions, Drexel University, Philadelphia, USA
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10
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Ribeiro F, Teixeira-Santos AC, Caramelli P, Leist AK. Prevalence of dementia in Latin America and Caribbean countries: Systematic review and meta-analyses exploring age, sex, rurality, and education as possible determinants. Ageing Res Rev 2022; 81:101703. [PMID: 35931410 PMCID: PMC9582196 DOI: 10.1016/j.arr.2022.101703] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 07/30/2022] [Accepted: 07/31/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Studies have shown that the prevalence of dementia in Latin America and the Caribbean (LAC) may be higher than in high-income countries. Thus, we sought to systematically analyse the prevalence of dementia and explore possible drivers that lead to this disparity in LAC countries. METHOD We searched Pubmed, Web of Knowledge, Scopus, Lilacs, and SciELO for studies on dementia in LAC countries published in English, Spanish, and Portuguese. Random-effects model was applied. RESULTS Thirty-one studies from 17 LAC countries were included. Pooled prevalence of all-cause dementia was 10.66%. Further analyses with studies providing raw prevalence by sex, area, and educational level showed a higher prevalence for women (8.97%) than for men (7.26%). Also, dementia prevalence was higher for rural than urban residents (7.71% vs 8.68%, respectively). Participants without formal education presented more than double the prevalence of dementia (21.37%) compared to those with at least one year of formal education (9.88%). Studies with more recent data collection showed higher dementia prevalence. CONCLUSION Our findings suggest a high global dementia prevalence in LAC countries and an unequal burden of dementia for women, lower-educated, and rural residents. Secular increases in dementia prevalence call for greater public health efforts for preventative actions.
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Affiliation(s)
- Fabiana Ribeiro
- Department of Social Sciences, University of Luxembourg Belval Campus, 11 Porte des Sciences, L-4366 Esch-sur-Alzette, Luxembourg,Correspondence to: University of Luxembourg, Department of Social Sciences, Esch-sur Alzette, Luxembourg.
| | - Ana C. Teixeira-Santos
- Department of Social Sciences, University of Luxembourg Belval Campus, 11 Porte des Sciences, L-4366 Esch-sur-Alzette, Luxembourg
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Alfredo Balena, 190 - sala 246, 30130-100 Belo Horizonte, Minas Gerais, Brazil
| | - Anja K. Leist
- Department of Social Sciences, University of Luxembourg Belval Campus, 11 Porte des Sciences, L-4366 Esch-sur-Alzette, Luxembourg
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11
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Brucki SMD, Aprahamian I, Borelli WV, Silveira VCD, Ferretti CEDL, Smid J, Barbosa BJAP, Schilling LP, Balthazar MLF, Frota NAF, Souza LCD, Vale FAC, Caramelli P, Bertolucci PHF, Chaves MLF, Nitrini R, Schultz RR, Morillo LS. Management in severe dementia: recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology. Dement Neuropsychol 2022. [DOI: 10.1590/1980-5764-dn-2022-s107en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
ABSTRACT Alzheimer’s disease (AD) and other neurodegenerative dementias have a progressive course, impairing cognition, functional capacity, and behavior. Most studies have focused on AD. Severe dementia is associated with increased age, higher morbidity-mortality, and rising costs of care. It is fundamental to recognize that severe dementia is the longest period of progression, with patients living for many years in this stage. It is the most heterogeneous phase in the process, with different abilities and life expectancies. This practice guideline focuses on severe dementia to improve management and care in this stage of dementia. As it is a long period in the continuum of dementia, clinical practice should consider non-pharmacological and pharmacological approaches. Multidisciplinary interventions (physical therapy, speech therapy, nutrition, nursing, and others) are essential, besides educational and support to caregivers.
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Affiliation(s)
| | - Ivan Aprahamian
- Faculdade de Medicina de Jundiaí, Brasil; University of Groningen, The Netherlands; Universidade de São Paulo, Brasil
| | | | | | | | | | - Breno José Alencar Pires Barbosa
- Universidade de São Paulo, Brazil; Universidade Federal de Pernambuco, Brasil; Instituto de Medicina Integral Prof. Fernando Figueira, Brasil
| | - Lucas Porcello Schilling
- Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil
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12
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Brucki SMD, Aprahamian I, Borelli WV, Silveira VCD, Ferretti CEDL, Smid J, Barbosa BJAP, Schilling LP, Balthazar MLF, Frota NAF, Souza LCD, Vale FAC, Caramelli P, Bertolucci PHF, Chaves MLF, Nitrini R, Schultz RR, Morillo LS. Manejo das demências em fase avançada: recomendações do Departamento Científico de Neurologia Cognitiva e do Envelhecimento da Academia Brasileira de Neurologia. Dement Neuropsychol 2022; 16:101-120. [DOI: 10.1590/1980-5764-dn-2022-s107pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 10/04/2021] [Accepted: 04/27/2022] [Indexed: 11/29/2022] Open
Abstract
RESUMO A doença de Alzheimer (DA) e outras demências neurodegenerativas têm um curso progressivo com comprometimento da cognição, capacidade funcional e comportamento. A maioria dos estudos enfocou a DA. A demência grave está associada ao aumento da idade, maior morbimortalidade e aumento dos custos de cuidados. É fundamental reconhecer que a demência grave é o período mais longo de progressão, com o paciente vivendo muitos anos nesta fase. É a fase mais heterogênea do processo, com diferentes habilidades e expectativa de vida. Esta diretriz de prática concentra-se na demência grave para melhorar o manejo e o cuidado nessa fase da demência. Como um longo período no continuum da demência, as abordagens não farmacológicas e farmacológicas devem ser consideradas. Intervenções multidisciplinares (fisioterapia, fonoaudiologia, nutrição, enfermagem, entre outras) são essenciais, além de educacionais e de apoio aos cuidadores.
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Affiliation(s)
| | - Ivan Aprahamian
- Faculdade de Medicina de Jundiaí, Brasil; University of Groningen, The Netherlands; Universidade de São Paulo, Brasil
| | | | | | | | | | - Breno José Alencar Pires Barbosa
- Universidade de São Paulo, Brazil; Universidade Federal de Pernambuco, Brasil; Instituto de Medicina Integral Prof. Fernando Figueira, Brasil
| | - Lucas Porcello Schilling
- Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil
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13
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Aravena JM, Gajardo J, Saguez R, Hinton L, Gitlin LN. Nonpharmacologic Interventions for Family Caregivers of People Living With Dementia in Latin-America: A Scoping Review. Am J Geriatr Psychiatry 2022; 30:859-877. [PMID: 34848116 DOI: 10.1016/j.jagp.2021.10.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Dementia prevalence in Latin America (LATAM) is rapidly increasing, contributing to significant family burden. As families are responsible for care, supportive interventions are critical. To understand the state-of-the-science, a scoping review was conducted of non-pharmacologic interventions for caregivers of people living with dementia (PLWD) in LATAM. DESIGN Eight databases were searched (PubMed, Embase, PsycINFO, Scopus, Scielo, Lilacs, Redalyc, Google Scholar) for nonpharmacological intervention studies published up to July, 2021 in LATAM reporting at least 1 caregiver outcome. A qualitative synthesis examined study designs, participants, and outcomes characteristics. RESULTS Forty-five studies were identified from 25.8% (n = 8/31) of LATAM countries (28 = Brazil, 4 = Chile, 4 = Cuba, 4 = México, 2 = Colombia, 1 = Perú, 1 = Ecuador, 1 = Argentina): 29% (n = 17) were randomized clinical trials (RCT), 7% (n = 3) nonrandomized comparison trials, 42% (n = 19) pre-post trials, 9% (n = 4) postintervention analyses, and 4% (n = 2) single case studies, comprising a total of 1,171 caregivers and 817 PLWD. For 20 RCT and nonrandomized comparison trials, 31 interventions were tested of which 48.4% (n = 15) targeted caregivers and 32.3% (n = 10) dyads. Most studies involved daughters with less than 12 years of education and tested multicomponent interventions involving disease education (90%), and cognitive behavioral coping (45%). Half of interventions (51.6%; n = 16/31) tested were adapted from other countries, and reported benefits for caregiver depression, quality of life, and burden. CONCLUSION Studies were conducted in a limited number of LATAM countries and few were RCTs. Results of RCTs showed benefits for socially vulnerable caregivers on psychosocial outcomes. There is an urgent need to rigorously evaluate more country/culturally specific interventions addressing unmet familial needs beyond psychosocial support.
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Affiliation(s)
- José M Aravena
- Department of Social and Behavioral Sciences (JMA), Yale University School of Public Health, New Haven, CT; Instituto de Investigación y Postgrado Facultad de Ciencias de la Salud (JMA), Universidad Central de Chile, Santiago, Chile
| | - Jean Gajardo
- Facultad de Ciencias para el Cuidado de la Salud (JG), Universidad San Sebastián, Santiago, Chile; Department of Occupational Therapy and Occupational Science (JG), University of Chile, Santiago, Chile
| | - Rodrigo Saguez
- Public Nutrition Unit, The Nutrition and Food Technology Institute (INTA) (RS), University of Chile, Santiago, Chile
| | - Ladson Hinton
- Department of Psychiatry and Behavioral Sciences (LH), University of California Davis School of Medicine, Sacramento, CA
| | - Laura N Gitlin
- College of Nursing and Health Professions (LNG), Drexel University, Philadelphia, PA; Center for Innovative Care in Aging (LNG), Johns Hopkins University, Baltimore, MA.
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14
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Malcorra BLC, Mota NB, Weissheimer J, Schilling LP, Wilson MA, Hübner LC. Reading and writing habits compensate for aging effects in speech connectedness. NPJ SCIENCE OF LEARNING 2022; 7:13. [PMID: 35676305 PMCID: PMC9178018 DOI: 10.1038/s41539-022-00129-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 05/18/2022] [Indexed: 05/06/2023]
Abstract
We investigate the association of short- and long-range recurrences (speech connectedness) with age, education, and reading and writing habits (RWH) in typical aging using an oral narrative production task. Oral narrative transcriptions were represented as word-graphs to measure short- and long-range recurrences. Speech connectedness was explained by the combination of age, education, and RWH, and the strength of RWH's coefficient reflects the aging effect.
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Affiliation(s)
- Bárbara L C Malcorra
- School of Humanities, Graduate Course in Linguistics, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.
| | - Natália B Mota
- Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
- Department of Physics, Federal University of Pernambuco (UFPE), Recife, PE, Brazil
| | - Janaina Weissheimer
- Brain Institute, Department of Foreign Languages and Literatures, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
- National Council for Scientific and Technological Development (CNPq), Brasília, DF, Brazil
| | - Lucas P Schilling
- School of Medicine, Graduate Course in Medicine and Healthy Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- School of Medicine, Graduate Course in Biomedical Gerontology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- Brain Institute of Rio Grande do Sul (InsCer), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Maximiliano A Wilson
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Département de réadaptation, Université Laval, Québec City, QC, Canada
| | - Lilian C Hübner
- School of Humanities, Graduate Course in Linguistics, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- National Council for Scientific and Technological Development (CNPq), Brasília, DF, Brazil
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15
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Chen Y, Caramelli P. Dementia among international migrants: an urgent call for better care. Eur J Neurol 2022; 29:1865-1866. [PMID: 35434895 PMCID: PMC9325533 DOI: 10.1111/ene.15361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 04/08/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Yaohua Chen
- Univ. Lille, Inserm URM_S1172, Memory Clinics, Department of Geriatrics, CHU Lille, F-59000, Lille, France
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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16
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Bernstein Sideman A, Al-Rousan T, Tsoy E, Piña Escudero SD, Pintado-Caipa M, Kanjanapong S, Mbakile-Mahlanza L, Okada de Oliveira M, De la Cruz-Puebla M, Zygouris S, Ashour Mohamed A, Ibrahim H, Goode CA, Miller BL, Valcour V, Possin KL. Facilitators and Barriers to Dementia Assessment and Diagnosis: Perspectives From Dementia Experts Within a Global Health Context. Front Neurol 2022; 13:769360. [PMID: 35418934 PMCID: PMC8997042 DOI: 10.3389/fneur.2022.769360] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/25/2022] [Indexed: 11/27/2022] Open
Abstract
Objectives Dementia poses one of the greatest global health challenges, affecting 50 million people worldwide. With 10 million new cases each year, dementia is a growing burden, particularly in low- and middle-income countries (LMIC). This study aimed to identify the facilitators and barriers to providing quality dementia assessment and care in LMICs from a global health perspective. Methods/Design A qualitative semi-structured interview study with 20 dementia expert healthcare providers from 19 countries. To be included, providers had to: practice dementia assessment or care in LMICs where the population over age 60 is projected to more than double by 2050 and be recognized as a leading dementia expert in the region based on position, research publications, and/or policy leadership. Interviews were analyzed by a multidisciplinary team of researchers using thematic analysis. Results Barriers to dementia assessment and care included stigma about dementia, poor patient engagement in and access to healthcare, inadequate linguistic and cultural validation, limited dementia capable workforce, competing healthcare system priorities, and insufficient health financing. Facilitators included the rise in dementia awareness campaigns, dementia training for general practitioners, availability of family support and family caregivers, and national and international collaborations including coordinated policy efforts and involvement in international research initiatives. Conclusions Findings from this study provide insights for prioritizing dementia assessment and care capacity-building in LMICs as a global health priority and for tailored public health approaches to strengthen dementia assessment and care at the individual, community, national, and multi-national levels.
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Affiliation(s)
- Alissa Bernstein Sideman
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, United States.,Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Department of Humanities and Social Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Tala Al-Rousan
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Herbert Wertheim School of Public Health, University of California, La Jolla, CA, United States
| | - Elena Tsoy
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Stefanie D Piña Escudero
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Maritza Pintado-Caipa
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Research Department, Peruvian Institute of Neurosciences, Lima, Peru
| | - Suchanan Kanjanapong
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Division of Geriatrics, Department of Preventive Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Lingani Mbakile-Mahlanza
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Department of Psychology, Faculty of Social Sciences, University of Botswana, Gaborone, Botswana
| | - Maira Okada de Oliveira
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Cognitive and Behavioral Neurology Unit, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil.,Hospital Santa Marcelina, São Paulo, São Paulo, Brazil
| | - Myriam De la Cruz-Puebla
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Neurosciences Institute, Autonomous University of Barcelona, Barcelona, Spain.,Cognition and Brain Plasticity Unit, University of Barcelona, Barcelona, Spain.,Bellvitge Institute for Biomedical Research, Barcelona, Spain.,Technical University of Ambato, Tungurahua, Ecuador
| | - Stelios Zygouris
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Centre for Research and Technology Hellas/Information Technologies Institute, Thessaloniki, Greece
| | - Aya Ashour Mohamed
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Department of Neurology, Ain Shams University, Cairo, Egypt
| | - Hany Ibrahim
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Geriatric Medicine Department, Ain Shams University, Cairo, Egypt
| | - Collette A Goode
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Bruce L Miller
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Victor Valcour
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Katherine L Possin
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
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17
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Borelli WV, Leotti VB, Strelow MZ, Chaves MLF, Castilhos RM. Preventable risk factors of dementia: Population attributable fractions in a Brazilian population-based study. LANCET REGIONAL HEALTH. AMERICAS 2022; 11:100256. [PMID: 36778926 PMCID: PMC9903643 DOI: 10.1016/j.lana.2022.100256] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background Knowledge regarding the modifiable risk factors of dementia is fundamental to guide public health policy. We aimed to estimate the population attributable fraction of modifiable risk factors of dementia among adults from a nationwide epidemiological study. Methods We used the public database of the Brazilian Longitudinal Study of Aging (ELSI-Brazil) to calculate the Population Attributable Fraction (PAF) for ten risk factors, including education level, hearing loss, hypertension, alcohol consumption, obesity, active smoking, depression, social isolation, physical inactivity, and diabetes. PAF was estimated for this sample after accounting for the communality of each risk factor. Findings The ten preventable risk factors for dementia accounted for 50·5% of the Population Attributable Fraction in Brazil. Hearing loss (14·2%), physical inactivity (11·2%), and hypertension (10·4%) accounted for the highest PAF among all the risk factors. Considerable variation in the relative contribution of the different risk factors was found in different regions. Interpretation This study might provide an opportunity to change the impact of dementia in Brazil. By targeting modifiable risk factors of dementia, the health of individuals in Brazil might be considerably improved. Funding This study did not receive any funding.
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Affiliation(s)
- Wyllians Vendramini Borelli
- Centro de Neurologia Cognitiva e do Comportamento, Serviço de Neurologia, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-903, Brazil
| | - Vanessa Bielefeldt Leotti
- Unidade de Bioestatística, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil,Departamento de Estatística, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Matheus Zschornack Strelow
- Centro de Neurologia Cognitiva e do Comportamento, Serviço de Neurologia, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-903, Brazil
| | - Márcia Lorena Fagundes Chaves
- Centro de Neurologia Cognitiva e do Comportamento, Serviço de Neurologia, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-903, Brazil
| | - Raphael Machado Castilhos
- Centro de Neurologia Cognitiva e do Comportamento, Serviço de Neurologia, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-903, Brazil,Corresponding author.
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18
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Pires LA, Almeida ALMD, Paraízo MDA, Corrêa JODA, Dias DDS, Fernandes NDS, Ezequiel DGA, Paula RBD, Fernandes NMDS. Cross-sectional assessment of mild cognitive impairment in pre-dialysis chronic kidney disease and its association with inflammation and changes seen on MRI: what the eyes cannot see. J Bras Nefrol 2022; 44:336-348. [PMID: 35167646 PMCID: PMC9518633 DOI: 10.1590/2175-8239-jbn-2021-0194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 09/11/2021] [Indexed: 12/05/2022] Open
Abstract
Introduction: Mild cognitive impairment (MCI) is a prevalent and underdiagnosed condition in chronic kidney disease (CKD), that shares common pathophysiological factors such as chronic inflammation. Objective: To evaluate the association of MCI in CKD stages 1-5 using inflammatory markers and changes by magnetic resonance imaging (MRI). Patients and Methods: Cross-sectional study in adult patients with pre-dialysis CKD. MCI was assessed by the Montreal Cognitive Assessment (MoCA) and the estimated glomerular filtration rate (eGFR) by the Chronic Kidney Disease Epidemiology Collaboration equation. Sociodemographic and clinical data were collected from medical records. The cytokines IL-4, IL-6, IL-17, TNF-α and hs-CRP were determined. Brain MRI was performed in a 1.5 Tesla device, without paramagnetic contrast. A descriptive analysis followed by a comparison of abnormal versus normal MoCA scores among all studied variables. A linear regression analysis was performed using MoCA as a dependent variable, adjusted for confounding factors. Results: Of 111 invited patients, eighty completed the neuropsychological assessment and 56 underwent MRI, and were included in the study. Mean age was 56.3 ± 8.3 years and 51.8% (n = 29) had altered MoCA. When compared to the group with normal MoCA, the group with altered MoCA had higher levels of IL-6 and IL-17. There was no correlation between altered MoCA with eGFR or with MRI abnormalities. Conclusão: MCI assessed by MoCA was prevalent in patients with pre-dialysis CKD, it was associated with inflammation and showed no correlation with MRI changes.
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Affiliation(s)
- Leopoldo Antônio Pires
- Universidade Federal de Juiz de Fora, Brasil; Universidade Federal de Juiz de Fora, Brasil
| | | | | | | | - Débora dos Santos Dias
- Universidade Federal de Juiz de Fora, Brasil; Universidade Federal de Juiz de Fora, Brasil
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19
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Kerwin D, Abdelnour C, Caramelli P, Ogunniyi A, Shi J, Zetterberg H, Traber M. Alzheimer's disease diagnosis and management: Perspectives from around the world. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12334. [PMID: 35898519 PMCID: PMC9309007 DOI: 10.1002/dad2.12334] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 05/11/2022] [Accepted: 05/18/2022] [Indexed: 11/17/2022]
Abstract
Alzheimer's disease (AD) and other dementias are a global challenge. Early diagnosis is important to manage the disease. However, there are barriers to diagnosis that differ by region. Researchers from Brazil, China, Nigeria, Spain, and Sweden have identified key barriers to AD diagnosis in their countries. In Brazil, socioeconomic inequalities and poor recognition of dementia by physicians can prevent diagnosis. In China, a very large population and lack of physician training in dementia make diagnosis problematic. In Nigeria, socioeconomic inequalities and cultural stigma can stand in the way of diagnosis. In Spain, patient hesitancy and an overloaded health-care system are barriers to diagnosis. In Sweden, inconsistent use of biomarkers is a prominent barrier to diagnosis of AD. To support diagnosis, more focus is needed on education of patients and physicians, increased use of support services, and improved access to biomarkers to accurately diagnose AD.
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Affiliation(s)
| | - Carla Abdelnour
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya Barcelona Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED) Instituto de Salud Carlos III Madrid Spain
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research Group, Faculdade de Medicina Universidade Federal de Minas Gerais Belo Horizonte Brazil
| | | | - Jiong Shi
- Lou Ruvo Center for Brain Health Cleveland Clinic Las Vegas Nevada USA
| | - 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 London UK.,UK Dementia Research Institute at UCL London UK.,Hong Kong Center for Neurodegenerative Diseases Hong Kong China
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20
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Vergara RC, Zitko P, Slachevsky A, San Martin C, Delgado C. Population attributable fraction of modifiable risk factors for dementia in Chile. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2022; 14:e12273. [PMID: 35229017 PMCID: PMC8864720 DOI: 10.1002/dad2.12273] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 11/04/2021] [Accepted: 11/15/2021] [Indexed: 11/10/2022]
Abstract
Introduction Methods Results Discussion HIGHLIGHTS
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Affiliation(s)
- Rodrigo C. Vergara
- Departamento de Kinesiología Facultad de Artes y Educación Física Universidad Metropolitana de Ciencias de la Educación Santiago Chile
| | - Pedro Zitko
- Health Service & Population Research Department IoPPN King's College London London UK
- Departamento de Salud Global Escuela de Salud Pública Universidad de Chile Santiago Chile
| | - Andrea Slachevsky
- Centro de Gerociencia Salud Mental y Metabolismo (GERO) Santiago Chile
- Laboratorio de Neuropsicología y Neurociencia Clínica (LANNEC) Departamento de Fisiopatología ‐ Instituto de Ciencias Biomédicas (ICBM) Departamento de Neurociencias Oriente Facultad de Medicina Universidad de Chile Santiago Chile
- Clínica de Memoria y Neuropsiquiatría (CMYN) Departamento de Neurología Hospital del Salvador y Facultad de Medicina Universidad de Chile Santiago Chile
- Servicio de Neurología Departamento de Medicina Clínica Alemana‐Universidad del Desarrollo Santiago Chile
- Departamento de Neurociencia Facultad de Medicina Universidad de Chile Santiago Chile
| | - Consuelo San Martin
- Departamento de Neurociencia Facultad de Medicina Universidad de Chile Santiago Chile
- Unidad de Cerebro Saludable Departamento de Neurología y Neurocirugía Hospital Clínico Universidad de Chile Independencia Santiago Chile
| | - Carolina Delgado
- Departamento de Neurociencia Facultad de Medicina Universidad de Chile Santiago Chile
- Unidad de Cerebro Saludable Departamento de Neurología y Neurocirugía Hospital Clínico Universidad de Chile Independencia Santiago Chile
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21
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Racine L, Ford H, Johnson L, Fowler-Kerry S. An integrative review of Indigenous informal caregiving in the context of dementia care. J Adv Nurs 2021; 78:895-917. [PMID: 34806198 DOI: 10.1111/jan.15102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 09/24/2021] [Accepted: 11/05/2021] [Indexed: 11/29/2022]
Abstract
AIMS To appraise the empirical literature on the needs of Indigenous informal caregivers caring for people living with dementia in Indigenous communities. DESIGN Whittemore and Knafl's updated approach to integrative reviews, PRISMA guidelines, and CASP checklists for narrative analysis were followed. DATA SOURCES A systematic search of published empirical literature from January 2010 to August 2020 was undertaken in six databases. REVIEW METHODS Fifty-one studies met the research question and the inclusion criteria. RESULTS Five themes describe the findings: Decolonizing Western perspectives on dementia, the centrality of cultural safety, caregivers' experiences, pre-dementia community education and family and community-centred care emerged from the thematic analysis. Most of the studies used quantitative methodologies, and few studies were conducted using community-based approaches. CONCLUSION This review shows that Indigenous caregiving represents an emerging field in nursing and health sciences in a context of a global crisis. Researchers need to focus on Indigenous values and voices to adapt care and support informal caregivers. Our review emphasizes that working with Indigenous communities will likely translate into new care delivery models, policies and practices to support Indigenous informal caregivers and address the specific social determinants impacting caregivers' roles and tasks. IMPACT This review highlights the necessity of having community and family-based discussions on enhancing the delivery of dementia care for Indigenous peoples in Canada and worldwide. Decolonizing Western perspectives of dementia translate into culturally safe approaches that aim to integrate Indigenous cultural perspectives of holism, reciprocity, wisdom, respect of older people and relationality into nursing practice. The support of Indigenous informal caregivers requires future studies to address the stigmatizing Western views of dementia.
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Affiliation(s)
- Louise Racine
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Harris Ford
- College of Arts and Science, Department of History, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Letitia Johnson
- College of Arts and Science, Department of History, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Susan Fowler-Kerry
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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22
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Ferretti C, Nitrini R, Brucki SMD. Virtual Support in Dementia: A Possible Viable Strategy for Caregivers. Front Neurol 2021; 12:662253. [PMID: 34484092 PMCID: PMC8409523 DOI: 10.3389/fneur.2021.662253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 07/02/2021] [Indexed: 11/21/2022] Open
Abstract
Background: In the last 10 months, due to the Covid-19 pandemic, several studies have shown that health education and virtual support strategies for caregivers of patients with dementia, in the management of home care, can be viable. Low and middle income countries, in particular, have sought to use these means to reduce the daily burden of caregivers, through virtual meetings of education and support. Objectives: To present the feasibility of a pilot study on the use of a support action contemplated by the Caad Project–indirect costs of dementia–from HC-FMUSP. Methods: Observational study in which 93 caregivers were invited to participate in virtual meetings on a frequency of three times/week, lasting 1 h each. Results: Of the 93 invited family members, and after 3 months, 42 answered eight questions about the effectiveness of the action. High percentages of positive responses regarding program satisfaction ranged from 86 to 100%. Conclusion: This study showed results of a very simple intervention that suggests that it is possible to offer caregivers of patients with dementia a program that can be used in primary care, in order to understand the difficulty of caregivers in their daily care of patients with dementia, with daily management guidelines on a case-by-case basis, in addition to promoting the implementation of an education strategy about the importance of knowing, and recognizing anatomophysiological changes in the aging process and its implications for the rupture of the imaginary line that involves senescence and senility. This allows the caregiver to feel able to protect his patient and himself by preventing the emergence of common diseases in this age group. Further studies are needed to explore this type of non-pharmacological support.
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Affiliation(s)
- Ceres Ferretti
- Cognitive and Behavioral Neurology Group, Faculty of Medicine, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil
| | - Ricardo Nitrini
- Cognitive and Behavioral Neurology Group, Faculty of Medicine, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil
| | - Sonia M D Brucki
- Cognitive and Behavioral Neurology Group, Faculty of Medicine, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil
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23
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César-Freitas KG, Suemoto CK, Power MC, Brucki SMD, Nitrini R. Incidence of dementia in a Brazilian population: The Tremembé Epidemiologic Study. Alzheimers Dement 2021; 18:581-590. [PMID: 34338427 DOI: 10.1002/alz.12423] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 06/04/2021] [Accepted: 06/08/2021] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Few dementia incidence studies have been performed in Latin America. We aimed to provide the incidence of dementia in a Brazilian community-dwelling elderly population. METHODS This study was conducted in urban and rural areas of Tremembé. The 520 participants without dementia at baseline were invited to participate in the follow-up. RESULTS After a median follow-up of 5 years, the incidence rate of dementia was 26.1 per 1000 person-years (PY) (95% confidence interval = 18.7-36.6/1000PY). This rate increased exponentially with age (8.3/1000PY for 60- to 64-year-olds to 110.2/1000PY for ≥80-year-olds) and lower education (10.5/1000PY for > 8 years of education to 59.2/1000PY for illiterates). Higher dementia risk was found among individuals with cognitive impairment no dementia at baseline. DISCUSSION The dementia incidence rate found was higher than in other countries in people under 65 years. Higher incidence in younger individuals is expected in developing countries probably due to low education and a high burden of cardiovascular diseases.
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Affiliation(s)
- Karolina G César-Freitas
- Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, São Paulo, Brazil
| | - Claudia K Suemoto
- Division of Geriatrics, University of São Paulo Medical School, São Paulo, Brazil
| | - Melinda C Power
- Department of Epidemiology, George Washington University, Washington, District of Columbia, USA
| | - Sonia M D Brucki
- Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, São Paulo, Brazil
| | - Ricardo Nitrini
- Cognitive and Behavioral Neurology Unit, Department of Neurology, Neurology, University of São Paulo Medical School, University of São Paulo, São Paulo, Brazil
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24
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Xiang Y, Vilmenay K, Poon AN, Ayanian S, Aitken CF, Chan KY. Systematic Review Estimating the Burden of Dementia in the Latin America and Caribbean Region: A Bayesian Approach. Front Neurol 2021; 12:628520. [PMID: 34393965 PMCID: PMC8356078 DOI: 10.3389/fneur.2021.628520] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 06/09/2021] [Indexed: 12/16/2022] Open
Abstract
Background: The global burden of dementia has increasingly shifted to low- and middle-income regions that lack essential data for monitoring epidemiological progression, and policy and planning support. Drawing upon data that have emerged since the last known estimates published in 2015, this study aims to update dementia estimates in the Latin America and Caribbean (LAC) region for the years 2020, 2030, and 2050 through the application of a recently validated Bayesian approach for disease estimates useful when data sources are scarce. Methods: A comprehensive parallel systematic review of PubMed, EMBASE, PsycINFO, Global Health, and LILACS was conducted to identify prospective population-based epidemiological studies on dementia published in English from 2013 to 2018 in LAC. English and non-English data cited by a recent review on dementia estimates in LAC were also examined for additional data. A Bayesian normal-normal hierarchical model (NNHM) was developed to estimate age-specific and age-adjusted dementia prevalence in people aged 60+. Using age-specific population projections from the UN, the total number of people affected by dementia for the years 2020, 2030, and 2050 were estimated. Results: 1,414 studies were identified, of which only 7 met the inclusion criteria. The studies had 7,684 participants and 1,191 dementia cases. The age-standardized prevalence of all forms of dementia in LAC was 8% (95% CI: 5–11.5%) in people aged 60+. The estimated prevalence varied with age, increasing from 2.5% (95% CI: 0.08–4.0%) in the 60-69 age group, to 9.4% (95% CI: 5.4–13.2%) in the 70–79 age group and 28.9% (95% CI: 20.3–37.2%) in the ≥80 age group. The number of people age 60 and older living with dementia in LAC in 2020 was estimated at 6.86 (95% CI: 4.3–9.8) million, 9.94 (95% CI: 6.16–14.15) million in 2030, and 19.33 (95% CI: 12.3–13.6) million in 2050. Conclusion: We project an upward disease trajectory for dementia in LAC countries. The projection is likely an underestimation of the true dementia burden given the underrepresentation of rural and socio-economically deprived populations. More research is urgently needed to improve the accuracy of disease estimates, guide clinicians to improve evaluations for earlier recognition of dementia, and support the development of effective policies for improving dementia prevention, diagnosis and clinical management in LAC's diverse and aging communities.
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Affiliation(s)
- Yawen Xiang
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom.,Edinburgh Medical School, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Kimberly Vilmenay
- College of Medicine, Howard University, Washington, DC, United States
| | - Adrienne N Poon
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom.,Department of Medicine, School of Medicine and Health Sciences, George Washington University, Washington, DC, United States
| | - Shant Ayanian
- Department of Medicine, School of Medicine and Health Sciences, George Washington University, Washington, DC, United States
| | - Christopher F Aitken
- Department of Economics, Edinburgh Business School, Heriot-Watt University, Edinburgh, United Kingdom
| | - Kit Yee Chan
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom.,Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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25
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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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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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27
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Nitrini R, Ferri CP. Burden of dementia in Brazil. ARQUIVOS DE NEURO-PSIQUIATRIA 2020; 78:755-756. [PMID: 33331511 DOI: 10.1590/0004-282x20200191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 11/09/2020] [Indexed: 11/22/2022]
Affiliation(s)
- Ricardo Nitrini
- Universidade de São Paulo, Medical School, Department of Neurology, São Paulo SP, Brazil
| | - Cleusa P Ferri
- Universidade Federal de São Paulo, Department of Psychiatry, São Paulo SP, Brazil
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28
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Ibanez A, Santamaria‐Garcia H, Guerrero Barragan A, Kornhuber A, Ton AMM, Slachevsky A, Teixeira AL, Mar Meza BM, Serrano CM, Cano C, Arias Gonzalez C, Gonzalez‐Billault C, Butler C, Bustin J, Duran‐Aniotz C, Acosta D, Matallana DL, Acosta‐Alvear D, Trépel D, Resende EDPF, de Oliveira FF, Ibanez F, De Felice FG, Navarrete G, Tarnanas I, Meier IB, Smid J, Llibre‐Guerra J, Llibre‐Rodriguez JJ, Fajersztajn L, Takada LT, Duque L, Okada de Oliveira M, Bicalho MAC, Behrens MI, Pintado‐Caipa M, Parra M, Wilson MZ, De La Cruz Puebla M, Custodio N, Santibanez R, Serafim RB, Tavares RM, Piña Escudero SD, Leon Rodriguez T, Dawson W, Miller BL, Kosik KS. The impact of SARS-CoV-2 in dementia across Latin America: A call for an urgent regional plan and coordinated response. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2020; 6:e12092. [PMID: 33283036 PMCID: PMC7683959 DOI: 10.1002/trc2.12092] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 09/11/2020] [Indexed: 01/15/2023]
Abstract
The SARS-CoV-2 global pandemic will disproportionately impact countries with weak economies and vulnerable populations including people with dementia. Latin American and Caribbean countries (LACs) are burdened with unstable economic development, fragile health systems, massive economic disparities, and a high prevalence of dementia. Here, we underscore the selective impact of SARS-CoV-2 on dementia among LACs, the specific strain on health systems devoted to dementia, and the subsequent effect of increasing inequalities among those with dementia in the region. Implementation of best practices for mitigation and containment faces particularly steep challenges in LACs. Based upon our consideration of these issues, we urgently call for a coordinated action plan, including the development of inexpensive mass testing and multilevel regional coordination for dementia care and related actions. Brain health diplomacy should lead to a shared and escalated response across the region, coordinating leadership, and triangulation between governments and international multilateral networks.
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Affiliation(s)
- Agustin Ibanez
- Global Brain Health Institute (GBHI)University of California San Francisco (UCSF)San FranciscoCaliforniaUSA
- Cognitive Neuroscience Center (CNC)Universidad de San AndrésBuenos AiresArgentina
- National Scientific and Technical Research Council (CONICET)Buenos AiresArgentina
- Center for Social and Cognitive Neuroscience (CSCN)Universidad Adolfo Ibanez, School of Psychology, Adolfo Ibañez UniversitySantiagoChile
- Universidad Autónoma del CaribeBarranquillaColombia
| | - Hernando Santamaria‐Garcia
- Pontificia Universidad Javeriana, Bogotá, Departamentos de Psiquiatría, Instituto de Envejecimiento, Centro de Memoria y Cognición IntellectusHospital Universitario San IgnacioBogotáColombia
| | - Alejandra Guerrero Barragan
- Global Brain Health Institute (GBHI)University of California San Francisco (UCSF)San FranciscoCaliforniaUSA
- Servicio de NeurologíaSubred de Servicios de Salud SuroccidenteBogotáColombia
| | - Alexander Kornhuber
- Global Brain Health Institute (GBHI)University of California San Francisco (UCSF)San FranciscoCaliforniaUSA
| | - Alyne Mendonca Marques Ton
- Laboratory of Translational Physiology and PharmacologyPharmaceutical Sciences Graduate Program, Vila Velha UniversityVila VelhaEspírito SantoBrazil
| | - 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 DesaConcepciónChile
| | | | - Beatriz Marcela Mar Meza
- Global Brain Health Institute (GBHI)University of California San Francisco (UCSF)San FranciscoCaliforniaUSA
| | - Cecilia M. Serrano
- Cognitive Neurology, Department of NeurologyCésar Milstein Hospital, ALMA (Asociación de Lucha contra el Mal de Alzheimer y alteraciones semejantes de la República Argentina), Research Ethics Committee, Ministry of Health of Buenos AiresBuenos AiresArgentina
| | - Carlos Cano
- Pontificia Universidad Javeriana, Bogotá, Departamentos de Psiquiatría, Instituto de Envejecimiento, Centro de Memoria y Cognición IntellectusHospital Universitario San IgnacioBogotáColombia
| | - Carolina Arias Gonzalez
- Neuroscience Research Institute and Department of Molecular Cellular and Developmental BiologyUniversity of California Santa BarbaraSanta BarbaraCaliforniaUSA
| | - Christian Gonzalez‐Billault
- Geroscience Center for Brain Health and Metabolism (GERO), Faculty of MedicineUniversity of ChileSantiagoChile
| | - Christopher Butler
- Department of Brain SciencesImperial CollegeLondonUK
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
- Department of NeurologyPontificia Universidad Católica de ChileSantiagoChile
| | - Julian Bustin
- Instituto de Neurología CognitivaINCYTBuenos AiresArgentina
| | - Claudia Duran‐Aniotz
- Center for Social and Cognitive Neuroscience (CSCN)Universidad Adolfo Ibanez, School of Psychology, Adolfo Ibañez UniversitySantiagoChile
- Geroscience Center for Brain Health and Metabolism (GERO), Faculty of MedicineUniversity of ChileSantiagoChile
- Biomedical Neuroscience Institute, Faculty of MedicineUniversity of ChileSantiagoChile
| | - Daisy Acosta
- Universidad Nacional Pedro Henriquez Ureña (UNPHU), Internal Medicine DepartmentGeriatric SectionSanto DomingoDominican Republic
| | - Diana L. Matallana
- Pontificia Universidad Javeriana, Bogotá, Departamentos de Psiquiatría, Instituto de Envejecimiento, Centro de Memoria y Cognición IntellectusHospital Universitario San IgnacioBogotáColombia
| | - Diego Acosta‐Alvear
- Neuroscience Research Institute and Department of Molecular Cellular and Developmental BiologyUniversity of California Santa BarbaraSanta BarbaraCaliforniaUSA
| | - Dominic Trépel
- Global Brain Health InstituteTrinity College DublinDublinIreland
| | - Elisa De Paula França Resende
- Global Brain Health Institute (GBHI)University of California San Francisco (UCSF)San FranciscoCaliforniaUSA
- Instituto de Ensino e PesquisaSanta Casa BHBelo HorizonteBrazil
- Federal University of Rio de JaneiroRio de JaneiroBrazil
| | - Fabricio Ferreira de Oliveira
- Department of Neurology and Neurosurgery, Escola Paulista de MedicinaFederal University of São Paulo ‐ UNIFESPSão PauloBrazil
| | | | - Fernanda G. De Felice
- Federal University of Rio de JaneiroRio de JaneiroBrazil
- Queen's UniversityKingstonOntarioCanada
| | - Gorka Navarrete
- Center for Social and Cognitive Neuroscience (CSCN)Universidad Adolfo Ibanez, School of Psychology, Adolfo Ibañez UniversitySantiagoChile
| | - Ioannis Tarnanas
- Altoida Inc.HoustonTexasUSA
- Swiss National Task Force for DementiaGenevaSwitzerland
| | - Irene B. Meier
- Altoida Inc.HoustonTexasUSA
- Swiss National Task Force for DementiaGenevaSwitzerland
| | - Jerusa Smid
- Department of NeurologyUniversity of Sao Paulo; Institute of Infectious Diseases Emilio RibasSão PauloBrazil
| | - Jorge Llibre‐Guerra
- Global Brain Health Institute (GBHI)University of California San Francisco (UCSF)San FranciscoCaliforniaUSA
- Department of NeurologyWashington University School of MedicineSt LouisUSA
| | | | - Laís Fajersztajn
- Global Brain Health Institute (GBHI)University of California San Francisco (UCSF)San FranciscoCaliforniaUSA
- Department of Pathology, Laboratory of Experimental Air PollutionUniversity of São Paulo School of MedicineSao PauloBrazil
| | | | - Lissette Duque
- Cognitive Disorders Unit, NeuromedicenterNational Commission in BioethicsQuitoEcuador
| | - Maira Okada de Oliveira
- Global Brain Health Institute (GBHI)University of California San Francisco (UCSF)San FranciscoCaliforniaUSA
- Hospital das ClinicasUniversity of Sao Paulo Medical SchoolSao PauloBrazil
- Hospital Santa MarcelinaSao PauloBrazil
| | | | - María Isabel Behrens
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department ‐ ICBM, Neuroscience and East Neuroscience Departments, Faculty of MedicineUniversity of ChileSantiagoChile
- FCEFyNUniversidad Nacional de San JuanSan JuanArgentina
- Departamento de Neurología and Neurocirugía Hospital Clínico, Departamento de NeurocienciasCentro de Investigación Clínica Avanzada (CICA) Facultad de Medicina, Hospital Clínico, Universidad de ChileSantiagoChile
| | - Maritza Pintado‐Caipa
- Global Brain Health Institute (GBHI)University of California San Francisco (UCSF)San FranciscoCaliforniaUSA
- Unit Cognitive Impairment and Dementia PreventionCognitive Neurology Center, Peruvian Institute of NeurosciencesLimaPeru
| | | | - Maxwell Z. Wilson
- Neuroscience Research Institute and Department of Molecular Cellular and Developmental BiologyUniversity of California Santa BarbaraSanta BarbaraCaliforniaUSA
| | - Myriam De La Cruz Puebla
- Global Brain Health Institute (GBHI)University of California San Francisco (UCSF)San FranciscoCaliforniaUSA
- Vall d'Hebron Research Institute (VHIR)Autonome University of BarcelonaBarcelonaSpain
| | - Nilton Custodio
- Unit Cognitive Impairment and Dementia PreventionCognitive Neurology Center, Peruvian Institute of NeurosciencesLimaPeru
| | - Rodrigo Santibanez
- Department of NeurologyPontificia Universidad Católica de ChileSantiagoChile
- Neurology ServiceComplejo Asistencial Dr. Sótero del RíoSantiagoChile
| | | | - Ronnielly Melo Tavares
- Federal University of Rio de JaneiroRio de JaneiroBrazil
- Behavioral Neurology ClinicSanta Casa de Belo HorizonteMGBrazil
| | | | - Tomas Leon Rodriguez
- Memory and Neuropsychiatric Clinic (CMYN), Neurology DepartmentDel Salvador Hospital and University of Chile Faculty of MedicineSantiagoChile
| | - Walter Dawson
- Global Brain Health Institute (GBHI)University of California San Francisco (UCSF)San FranciscoCaliforniaUSA
- Department of NeurologySchool of Medicine, Oregon Health and Science UniversityPortlandOregonUSA
- Institute on AgingCollege of Urban and Public Affairs, Portland State UniversityPortlandOregonUSA
| | - Bruce L. Miller
- Global Brain Health Institute (GBHI)University of California San Francisco (UCSF)San FranciscoCaliforniaUSA
| | - Kenneth S. Kosik
- Neuroscience Research Institute and Department of Molecular Cellular and Developmental BiologyUniversity of California Santa BarbaraSanta BarbaraCaliforniaUSA
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29
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Chan KY, Adeloye D, Asante KP, Calia C, Campbell H, Danso SO, Juvekar S, Luz S, Mohan D, Muniz-Terrera G, Nitrini R, Noroozian M, Nulkar A, Nyame S, Paralikar V, Parra Rodriguez MA, Poon AN, Reidpath DD, Rudan I, Stephan BCM, Su T, Wang H, Watermeyer T, Wilkinson H, Yassuda MS, Yu X, Ritchie C. Tackling dementia globally: the Global Dementia Prevention Program (GloDePP) collaboration. J Glob Health 2019; 9:020103. [PMID: 31893025 PMCID: PMC6925964 DOI: 10.7189/jogh.09.020103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Kit Yee Chan
- Centre for Global Health, Usher Institute, University of Edinburgh, United Kingdom
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - Davies Adeloye
- Centre for Global Health, Usher Institute, University of Edinburgh, United Kingdom
- RcDavies Evidence-based Medicine, Lagos, Nigeria
| | - Kwaku Poku Asante
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
| | - Clara Calia
- Department of Clinical Psychology, School of Health in Social Science, Medical School, The University of Edinburgh, United Kingdom
| | - Harry Campbell
- Centre for Global Health, Usher Institute, University of Edinburgh, United Kingdom
| | - Samuel O Danso
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, United Kingdom
| | - Sanjay Juvekar
- King Edward Memorial Hospital Research Centre (KEMHRC), Pune, India
| | - Saturnino Luz
- Usher Institute, University of Edinburgh, United Kingdom
| | - Devi Mohan
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia
- South East Asia Community Observatory, Monash University Malaysia, Malaysia
| | - Graciela Muniz-Terrera
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, United Kingdom
| | - Ricardo Nitrini
- Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo (SP), Brazil
| | | | - Amit Nulkar
- King Edward Memorial Hospital Research Centre (KEMHRC), Pune, India
| | - Solomon Nyame
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
| | | | - Mario A Parra Rodriguez
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, United Kingdom
- Autonomous University of the Caribbean, Barranquilla, Colombia
| | - Adrienne N. Poon
- Centre for Global Health, Usher Institute, University of Edinburgh, United Kingdom
- Department of Medicine, George Washington School of Medicine & Health Sciences, Washington, DC, United States
| | | | - Igor Rudan
- Centre for Global Health, Usher Institute, University of Edinburgh, United Kingdom
| | - Blossom CM Stephan
- Institute of Mental Health, Division of Psychiatry and Applied Psychology, School of Medicine, Nottingham University, United Kingdom
| | - TinTin Su
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia
- South East Asia Community Observatory, Monash University Malaysia, Malaysia
| | - Huali Wang
- Dementia Care & Research Centre, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- National Clinical Research Centre for Mental Disorders, Key Laboratory for Mental Health, Beijing, China
| | - Tam Watermeyer
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, United Kingdom
- Department of Psychology, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Heather Wilkinson
- Edinburgh – Centre for Research on the Experience of Dementia, School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Monica Sanches Yassuda
- Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo (SP), Brazil
- Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil
| | - Xin Yu
- Dementia Care & Research Centre, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- National Clinical Research Centre for Mental Disorders, Key Laboratory for Mental Health, Beijing, China
| | - Craig Ritchie
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, United Kingdom
| | - on behalf of the Global Dementia Prevention Program (GloDePP)
- Centre for Global Health, Usher Institute, University of Edinburgh, United Kingdom
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Australia
- RcDavies Evidence-based Medicine, Lagos, Nigeria
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
- Department of Clinical Psychology, School of Health in Social Science, Medical School, The University of Edinburgh, United Kingdom
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, United Kingdom
- King Edward Memorial Hospital Research Centre (KEMHRC), Pune, India
- Usher Institute, University of Edinburgh, United Kingdom
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia
- South East Asia Community Observatory, Monash University Malaysia, Malaysia
- Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo (SP), Brazil
- Tehran University of Medical Sciences (TUMS), Tehran, Iran
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, United Kingdom
- Alzheimer’s Scotland Dementia Research Centre, Edinburgh University, United Kingdom
- Autonomous University of the Caribbean, Barranquilla, Colombia
- Department of Medicine, George Washington School of Medicine & Health Sciences, Washington, DC, United States
- Health System and Population Studies Division, icddr,b Bangladesh
- Institute of Mental Health, Division of Psychiatry and Applied Psychology, School of Medicine, Nottingham University, United Kingdom
- Dementia Care & Research Centre, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- Beijing Dementia Key Lab, Beijing, China
- National Clinical Research Centre for Mental Disorders, Key Laboratory for Mental Health, Beijing, China
- Department of Psychology, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
- Edinburgh – Centre for Research on the Experience of Dementia, School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom
- Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil
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