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Ferreira MG, Mariano LI, Rezende JVD, Caramelli P, Kishita N. Corrigendum to "Effects of group acceptance and commitment therapy (ACT) on anxiety and depressive symptoms in adults: A meta-analysis" [J. Affect. Disord. 309 (2022) 297-308]. J Affect Disord 2024; 355:325. [PMID: 38579604 DOI: 10.1016/j.jad.2024.03.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Affiliation(s)
- Michele Gomes Ferreira
- Programa de Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Faculdade de Medicina da Universidade Federal de Minas Gerais, Brazil
| | - Luciano Inácio Mariano
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais, Brazil
| | - Junio Vieira de Rezende
- Programa de Pós-Graduação em Psicologia, Faculdade de Filosofia e Ciências Humanas, Universidade Federal de Minas Gerais, Brazil
| | - Paulo Caramelli
- Programa de Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Faculdade de Medicina da Universidade Federal de Minas Gerais, Brazil; Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Brazil
| | - Naoko Kishita
- School of Health Science, University of East Anglia, United Kingdom.
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Kishita N, Ferreira MG, Caramelli P. Correspondence to: Comment on Ferreira, M. G., et al. (2022) Effects of group Acceptance and Commitment Therapy (ACT) on anxiety and depressive symptoms in adults: A meta-analysis. J Affect Disord, 309, 297-308. J Affect Disord 2024; 355:315-316. [PMID: 38561156 DOI: 10.1016/j.jad.2024.03.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/04/2024]
Affiliation(s)
- Naoko Kishita
- School of Health Science, University of East Anglia, United Kingdom.
| | - Michele Gomes Ferreira
- Programa de Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Faculdade de Medicina da Universidade Federal de Minas Gerais, Brazil
| | - Paulo Caramelli
- Programa de Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Faculdade de Medicina da Universidade Federal de Minas Gerais, Brazil; Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Brazil
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Dantas JM, Mutarelli A, Navalha DDP, Dagostin CS, Romeiro PHCL, Felix N, Nogueira A, Batista S, Teixeira L, Caramelli P. Efficacy of anti-amyloid-ß monoclonal antibody therapy in early Alzheimer's disease: a systematic review and meta-analysis. Neurol Sci 2024; 45:2461-2469. [PMID: 37978096 DOI: 10.1007/s10072-023-07194-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Studies targeting amyloid-ß in patients with Alzheimer's disease (AD) have conflicting results and early initiation of therapy may yield better outcomes. METHODS We systematically searched PubMed, Embase, Cochrane Library, and Clinicaltrials.gov for randomized trials comparing monoclonal antibodies (mAbs) with placebo in MCI or mild dementia due to AD. RESULTS Nineteen studies comprising 15,275 patients were included. In patients with early AD, mAbs reduced the rate of decline, in both the Clinical Dementia Rating Scale, the sum of boxes (CDR-SB; MD -0.30; 95% CI -0.42,-0.19; p < 0.01), and the Alzheimer's Disease Assessment Scale, cognitive subscore (ADAS-cog; SMD -0.80; 95% CI -10.25,-0.35; p < 0.01). The results were similar between clinical stages for CDR-SB (MCI, MD -0.19; 95% CI -0.35,-0.03; p = 0.02; mild dementia, MD -0.45; 95% CI -0.65,-0.25; p < 0.01; subgroup differences, p = 0.13), as well as for ADAS-Cog (MCI, SMD -0.83; 95% CI -1.49,-0.17; p = 0.01; mild dementia, SMD -0.69; 95% CI -1.32 to -0.05; p = 0.03; subgroup differences, p = 0.47). The risk of amyloid-related imaging abnormalities (ARIA) was significantly higher in patients taking mAbs, including ARIA-edema (RR 7.7; 95% CI 4.60 to 13.00; p < 0.01), ARIA-hemorrhage (RR 1.8; 95% CI 1.22 to 2.59; p < 0.01), and symptomatic or serious ARIA (RR 14.1; 95% CI 7.30 to 27.14; p < 0.01). CONCLUSION Anti-amyloid-ß mAbs attenuate cognitive and functional decline compared with placebo in early AD; whether the magnitude of this effect is clinically important remains uncertain, especially relative to the safety profile of these medications. Starting immunotherapy in patients with MCI was not significantly different than starting in the mild dementia stage. PROSPERO REGISTRY CRD42023430698.
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Affiliation(s)
- Julyana M Dantas
- Universidade Federal do Rio Grande do Norte, Av. Nilo Peçanha, 620 - Petrópolis, Natal, RN, 59012-300, Brazil.
| | | | | | | | | | - Nicole Felix
- Universidade Federal de Campina Grande, Campina Grande, Brazil
| | - Alleh Nogueira
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | - Sávio Batista
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Paulo Caramelli
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Athanasio BS, Oliveira ACDS, Pedrosa AL, Borges RS, Neto AOM, Oliveira RA, de Resende EDPF, de Moraes RF, Caramelli P, de Souza LC. The role of brain perfusion SPECT in the diagnosis of frontotemporal dementia: A systematic review. J Neuroimaging 2024; 34:308-319. [PMID: 38192155 DOI: 10.1111/jon.13189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND AND PURPOSE Frontotemporal dementia (FTD) is the second most common cause of presenile dementia. The clinical distinction between FTD, Alzheimer's disease (AD), and other dementias is a clinical challenge. Brain perfusion SPECT may contribute to the diagnosis of FTD, but its value is unclear. METHODS We performed a systematic review to investigate the diagnostic accuracy of the brain SPECT in (1) distinguishing FTD from AD and other dementias and (2) differentiating FTD variants. RESULTS Overall, 391 studies were retrieved on the initial search and 35 studies composed the final selection, comprising a total number of 3142 participants of which 1029 had FTD. The sensitivity and the specificity for the differential diagnosis of FTD versus AD ranged from 56% to 88% and from 51% to 93%, respectively. SPECT is not superior to the clinical method of diagnosis, but the combination of SPECT with clinical data seems to improve the diagnostic accuracy. CONCLUSION Brain perfusion SPECT has a limited value in the diagnostic framework of FTD. SPECT can be performed when FDG-PET is not available. SPECT is recommended only for selected cases when the diagnosis is challenging using conventional methods.
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Affiliation(s)
- Bruno S Athanasio
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | | - Ana Luísa Pedrosa
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Rafael S Borges
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Avelar O M Neto
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Rafael A Oliveira
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Elisa de Paula França de Resende
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
- Grupo de Neurologia Cognitiva e do Comportamento, Faculdade de Medicina da UFMG, Belo Horizonte, Brazil
| | - Renata Freire de Moraes
- Instituto Hermes Pardini, Belo Horizonte, Brazil
- Programa de Pós-Graduação em Neurociências, UFMG, Belo Horizonte, Brazil
| | - Paulo Caramelli
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
- Grupo de Neurologia Cognitiva e do Comportamento, Faculdade de Medicina da UFMG, Belo Horizonte, Brazil
- Programa de Pós-Graduação em Neurociências, UFMG, Belo Horizonte, Brazil
| | - Leonardo Cruz de Souza
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
- Grupo de Neurologia Cognitiva e do Comportamento, Faculdade de Medicina da UFMG, Belo Horizonte, Brazil
- Programa de Pós-Graduação em Neurociências, UFMG, Belo Horizonte, Brazil
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Maestre G, Hill C, Griffin P, Hall S, Hu W, Flatt J, Babulal G, Thorpe R, Henderson JN, Buchwald D, Manson S, Cicero E, Gilmore‐Bykovskyi A, Gamaldo A, Glover C, Barnes L, Kind A, James B, Zeki Al Hazzouri A, Wharton W, Caramelli P, Szanton S, Whitmer R, Benn Torres J, Deters K, Okonkwo O, Das R, Martinez‐Gonzalez K, Carrillo M. Promoting diverse perspectives: Addressing health disparities related to Alzheimer's and all dementias. Alzheimers Dement 2024; 20:3099-3107. [PMID: 38460119 PMCID: PMC11032522 DOI: 10.1002/alz.13752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 03/11/2024]
Abstract
Dementia research lacks appropriate representation of diverse groups who often face substantial adversity and greater risk of dementia. Current research participants are primarily well-resourced, non-Hispanic White, cisgender adults who live close to academic medical centers where much of the research is based. Consequently, the field faces a knowledge gap about Alzheimer's-related risk factors in those other groups. The Alzheimer's Association hosted a virtual conference on June 14-16, 2021, supported in part by the National Institute on Aging (R13 AG072859-01), focused on health disparities. The conference was held entirely online and consisted of 2 days of core programming and a day of focused meetings centered on American Indian and Alaska Natives and on LGBTQIA+ populations. Over 1300 registrants attended discussions focused on the structural and systemic inequities experienced across diverse groups, as well as ways to investigate and address these inequities.
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Affiliation(s)
- Gladys Maestre
- School of MedicineAlzheimer's Disease Resource Center for Minority Aging ResearchUniversity of Texas Rio Grande ValleyBrownsvilleTexasUSA
| | - Carl Hill
- Medical & Scientific RelationsAlzheimer's AssociationChicagoIllinoisUSA
| | - Percy Griffin
- Medical & Scientific RelationsAlzheimer's AssociationChicagoIllinoisUSA
| | - Stephen Hall
- Medical & Scientific RelationsAlzheimer's AssociationChicagoIllinoisUSA
| | - William Hu
- Rutgers Robert Wood Johnson Medical School and Rutgers Institute for HealthHealth Care Policy, and Aging ResearchNew BrunswickNew JerseyUSA
| | - Jason Flatt
- Department of Social and Behavioral HealthSchool of Public HealthUniversity of Nevada Las VegasLas VegasNevadaUSA
| | - Ganesh Babulal
- Department of NeurologySchool of MedicineWashington University in St. LouisSt. LouisMissouriUSA
| | - Roland Thorpe
- Center on AgingCenter on Health Disparities SolutionsHopkins Population CenterAlzheimer's Disease Resource Center for Minority Aging ResearchJohns Hopkins University Bloomberg School of Public HealthBaltimoreMarylandUSA
| | | | - Dedra Buchwald
- Institute for Research and Education to Advance Community Health Elson S Floyd College of Medicine Washington State UniversitySeattleWashingtonUSA
| | - Spero Manson
- Centers for American Indian and Alaska Native HealthUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Ethan Cicero
- Nell Hodgson Woodruff School of NursingEmory UniversityAtlantaGeorgiaUSA
| | - Andrea Gilmore‐Bykovskyi
- BerbeeWalsh Department of Emergency MedicineUniversity of Wisconsin‐Madison School of Medicine and Public HealthMadisonWisconsinUSA
| | - Alyssa Gamaldo
- Pennsylvania State UniversityState CollegePennsylvaniaUSA
| | | | - Lisa Barnes
- Rush University Medical CenterChicagoIllinoisUSA
| | - Amy Kind
- BerbeeWalsh Department of Emergency MedicineUniversity of Wisconsin‐Madison School of Medicine and Public HealthMadisonWisconsinUSA
| | - Bryan James
- Rush University Medical CenterChicagoIllinoisUSA
| | - Adina Zeki Al Hazzouri
- Mailman School of Public HealthDepartment of EpidemiologyColumbia UniversityNew YorkNew YorkUSA
| | - Whitney Wharton
- Nell Hodgson Woodruff School of NursingEmory UniversityAtlantaGeorgiaUSA
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Unit, Faculdade de MedicinaUniversidade Federal de Minas GeraisBelo HorizonteBrazil
| | - Sarah Szanton
- Johns Hopkins University School of NursingBaltimoreMarylandUSA
| | - Rachel Whitmer
- Department of Public Health SciencesDepartment of NeurologyUniversity of California DavisDavisCaliforniaUSA
| | | | - Kacie Deters
- Department of NeurosciencesUniversity of California San Diego School of MedicineLa JollaCaliforniaUSA
| | - Ozioma Okonkwo
- Department of Medicine and the Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Rina Das
- National Institute on Minority Health and Health DisparitiesBethesdaMarylandUSA
| | | | - Maria Carrillo
- Medical & Scientific RelationsAlzheimer's AssociationChicagoIllinoisUSA
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de Almeida MA, Barbosa MT, Resende EDPF, Carvalho VA, Santos APB, Machado JCB, Lara VP, Gomes KB, Machado TH, Caramelli P. Association of Alcohol Consumption with Cognition and Functionality in Older Adults Aged 75+ Years: The Pietà Study. Can J Aging 2024:1-11. [PMID: 38467581 DOI: 10.1017/s0714980824000126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024] Open
Abstract
The relationship between alcohol consumption and cognition is still controversial. This is a cross-sectional population-based study conducted in Caeté (MG), Brazil, where 602 individuals aged 75+ years, 63.6% female, and with a mean education of 2.68 years, were submitted to thorough clinical assessments and categorized according to the number of alcoholic beverages consumed weekly. The prevalence rates of previous and current alcohol consumption were 34.6% and 12.3%, respectively. No association emerged between cognitive diagnoses and current/previous alcohol consumption categories. Considering current alcohol intake as a dichotomous variable, the absence of alcohol consumption was associated with dementia (OR = 2.34; 95%CI: 1.39-3.90) and worse functionality (p = 0.001). Previous consumption of cachaça (sugar cane liquor) increased the risk of dementia by 2.52 (95%CI: 1.25-5.04). The association between the consumption of cachaça and dementia diagnosis has not been described before.
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Affiliation(s)
- Mariana Alves de Almeida
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Maira Tonidandel Barbosa
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Elisa de Paula França Resende
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, MG, Brazil
- Hospital das Clínicas da Universidade Federal de Minas Gerais/EBSERH, Belo Horizonte, MG, Brazil
| | - Viviane Amaral Carvalho
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ana Paula Borges Santos
- Hospital das Clínicas da Universidade Federal de Minas Gerais/EBSERH, Belo Horizonte, MG, Brazil
| | | | - Vivian Proença Lara
- Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Karina Braga Gomes
- Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Thais Helena Machado
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Departamento de Fonoaudiologia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Pereira JD, Teixeira LCR, Mamede I, Alves MT, Caramelli P, Luizon MR, Veloso AA, Gomes KB. miRNAs in cerebrospinal fluid associated with Alzheimer's disease: A systematic review and pathway analysis using a data mining and machine learning approach. J Neurochem 2024. [PMID: 38390627 DOI: 10.1111/jnc.16060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 12/20/2023] [Accepted: 01/13/2024] [Indexed: 02/24/2024]
Abstract
Alzheimer's disease (AD) is the most common type and accounts for 60%-70% of the reported cases of dementia. MicroRNAs (miRNAs) are small non-coding RNAs that play a crucial role in gene expression regulation. Although the diagnosis of AD is primarily clinical, several miRNAs have been associated with AD and considered as potential markers for diagnosis and progression of AD. We sought to match AD-related miRNAs in cerebrospinal fluid (CSF) found in the GeoDataSets, evaluated by machine learning, with miRNAs listed in a systematic review, and a pathway analysis. Using machine learning approaches, we identified most differentially expressed miRNAs in Gene Expression Omnibus (GEO), which were validated by the systematic review, using the acronym PECO-Population (P): Patients with AD, Exposure (E): expression of miRNAs, Comparison (C): Healthy individuals, and Objective (O): miRNAs differentially expressed in CSF. Additionally, pathway enrichment analysis was performed to identify the main pathways involving at least four miRNAs selected. Four miRNAs were identified for differentiating between patients with and without AD in machine learning combined to systematic review, and followed the pathways analysis: miRNA-30a-3p, miRNA-193a-5p, miRNA-143-3p, miRNA-145-5p. The pathways epidermal growth factor, MAPK, TGF-beta and ATM-dependent DNA damage response, were regulated by these miRNAs, but only the MAPK pathway presented higher relevance after a randomic pathway analysis. These findings have the potential to assist in the development of diagnostic tests for AD using miRNAs as biomarkers, as well as provide understanding of the relationship between different pathophysiological mechanisms of AD.
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Affiliation(s)
- Jessica Diniz Pereira
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Izabela Mamede
- Intituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Paulo Caramelli
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Marcelo Rizzatti Luizon
- Intituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Adriano Alonso Veloso
- Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Karina Braga Gomes
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Ferreira NV, Gonçalves NG, Szlejf C, Goulart AC, de Souza Santos I, Duncan BB, Schmidt MI, Barreto SM, Caramelli P, Feter N, Castilhos RM, Drager LF, Lotufo P, Benseñor I, Suemoto CK. Optimal cardiovascular health is associated with slower cognitive decline. Eur J Neurol 2024; 31:e16139. [PMID: 38015440 DOI: 10.1111/ene.16139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Life's Simple 7, a lifestyle and cardiovascular index associated with cognition, has been updated to Life's Essential 8 (LE8) to include sleep. LE8 has been related to cardiovascular outcomes but its association with cognition is unclear. METHODS In this longitudinal analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), LE8 score was based on health behaviors (diet, physical activity, nicotine exposure, and sleep health) as well as health-related factors (body mass index, blood lipids, blood glucose, and blood pressure). Cognition was assessed in three waves, 4 years apart, using the Consortium to Establish a Registry for Alzheimer's Disease - Word List, semantic and phonemic verbal fluency, the Trail-Making Test B (TMT-B), and a global composite score. We used linear mixed-model analysis, inverse probability weighting, and interaction analysis. RESULTS At baseline, the mean age of the study cohort was 51.4 ± 8.9 years, 56% were women, and 53% were White. Higher baseline LE8 scores were associated with slower decline in global cognition (β = 0.001, 95% confidence interval [CI] 0.001, 0.002; p < 0.001), memory (β = 0.001, 95% CI 0.000, 0.002; p = 0.013), verbal fluency (β = 0.001, 95% CI 0.000, 0.002; p = 0.003), and TMT-B (β = 0.004, 95% CI 0.003, 0.005; p < 0.001). This association was mainly driven by LE8 health factors, particularly blood glucose and blood pressure. Age, sex, and race were modifiers of the association between LE8 and global cognitive decline (p < 0.001), suggesting it was more pronounced in older, male, and Black participants. CONCLUSIONS Higher baseline LE8 scores were associated with slower global and domain-specific cognitive decline during 8 years of follow-up, mainly due to health factors such as blood glucose and blood pressure. Sociodemographic factors were modifiers of this association.
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Affiliation(s)
- Naomi Vidal Ferreira
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
- Faculdade Adventista da Amazonia, Benevides, Brazil
| | | | - Claudia Szlejf
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Alessandra C Goulart
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Itamar de Souza Santos
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
- Department of Internal Medicine, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Bruce B Duncan
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria Inês Schmidt
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Sandhi Maria Barreto
- Deparment of Preventive and Social Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Natan Feter
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Luciano F Drager
- Unidade de Hipertensão, Instituto do Coracao (InCor), Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
- Unidade de Hipertensão, Disciplina de Nefrologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Paulo Lotufo
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Isabela Benseñor
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Claudia Kimie Suemoto
- Division of Geriatrics, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
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Fitri FI, Naci L, Turana Y, Rambe AS, Nazriani D, Nitrini R, Caramelli P. Modified Brief Cognitive Screening Battery - Indonesian Version: cross-cultural adaptation and normative data based on demographic factors in North Sumatra, Indonesia. Front Neurol 2024; 14:1306356. [PMID: 38288332 PMCID: PMC10822921 DOI: 10.3389/fneur.2023.1306356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/28/2023] [Indexed: 01/31/2024] Open
Abstract
Introduction Key component of early detection of dementia is a brief and culturally appropriate cognitive screening tool. This study aimed to perform a cultural adaptation of the Brief Cognitive Screening Battery (BCSB) and to obtain normative data from the older adult population. Methods Cross-cultural adaptation process to develop BCSB-INA was performed. This was followed by a feasibility study from community dwelling older adults from several urban and rural areas in North Sumatra, Indonesia. Results The BCSB-INA was generally well understood and showed not much discrepancy in translation from the original version. There were differences in semantic and phonemic fluency and CDT based on years of education, but no difference was found on other domain, including the delayed recall of the FMT. The battery was more influenced by age than education. Discussion The BCSB-INA is culturally appropriate and feasible to be used in population with heterogenous educational background in Indonesia.
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Affiliation(s)
- Fasihah Irfani Fitri
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
- Department of Neurology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Lorina Naci
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Yuda Turana
- School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Aldy Safruddin Rambe
- Department of Neurology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Dina Nazriani
- Faculty of Psychology, Universitas Sumatera Utara, Medan, Indonesia
| | - Ricardo Nitrini
- Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Research Group, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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10
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Olavarría L, Caramelli P, Lema J, Andrade CBD, Pinto A, Azevedo LVDS, Thumala D, Vieira MCS, Rossetti AP, Generoso AB, Carmona KC, Sepúlveda-Loyola W, Pinto LAC, Barbosa MT, Slachevsky A. Impact of the Pandemic Time on the Mental Health of People with Dementia and Their Family Caregivers in Brazil and Chile: One-Year Follow-Up. J Alzheimers Dis 2024; 98:691-698. [PMID: 38427488 DOI: 10.3233/jad-231310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
Background Previous studies reported the negative impact of social isolation on mental health in people with dementia (PwD) and their caregivers, butlongitudinal studies seem scarcer. Objective To describe a one-year follow-up impact of the COVID-19 pandemic on PwD and their caregivers in both Brazil and Chile. Methods This study analyzed the impact of the pandemic on the psychological and physical health of PwD and their family caregivers after one year of follow-up in three outpatient clinics in Brazil (n = 68) and Chile (n = 61). Results In both countries, PwD reduced their functional capacity after one year of follow-up (p = 0.017 and p = 0.009; respectively) and caregivers reported worse physical and mental health (p = 0.028 and p = 0.039). Only in Chile, caregivers reported more sadness associated with care (p = 0.001), and reduced time sleeping (p = 0.07). Conclusions In conclusion, the COVID-19 pandemic appears to have had a long-lasting impact on PwD and their caregivers. However, it is essential to acknowledge that the inherent progression of dementia itself may also influence changes observed over a year.
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Affiliation(s)
- Loreto Olavarría
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Physiopathology Department - Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Universidad de Chile, Santiago, Chile
- Psychiatry Department, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibanez, Santiago, Chile
| | - Paulo Caramelli
- Faculdade de Medicina, Behavioral and Cognitive Neurology Research Group, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - José Lema
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
| | - Caíssa Bezerra de Andrade
- Faculdade de Medicina, Behavioral and Cognitive Neurology Research Group, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Alejandra Pinto
- Neurology Department, Memory and Neuropsychiatric Center (CMYN), Memory Unit, Hospital del Salvador and Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Lílian Viana Dos Santos Azevedo
- Faculdade de Medicina, Behavioral and Cognitive Neurology Research Group, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Daniela Thumala
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Department of Psychology, Faculty of Social Sciences, University of Chile, Santiago, Chile
| | | | | | | | - Karoline Carvalho Carmona
- Faculdade de Medicina, Behavioral and Cognitive Neurology Research Group, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Ludmilla Aparecida Cardoso Pinto
- Faculdade de Medicina, Behavioral and Cognitive Neurology Research Group, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Maira Tonidandel Barbosa
- Faculdade de Medicina, Behavioral and Cognitive Neurology Research Group, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Faculdade Ciências Médicas de Minas Gerais, Geriatric Medicine, Belo Horizonte, Brazil
| | - Andrea Slachevsky
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Physiopathology Department - Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Universidad de Chile, Santiago, Chile
- Neurology Department, Memory and Neuropsychiatric Center (CMYN), Memory Unit, Hospital del Salvador and Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Departamento de Medicina, Servicio de Neurología, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
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11
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de Melo Queiroz E, Marques Couto C, da Cruz Mecone CA, Souza Lima Macedo W, Caramelli P. Clinical profile and survival analysis of Alzheimer's disease patients in a Brazilian cohort. Neurol Sci 2024; 45:129-137. [PMID: 37540343 DOI: 10.1007/s10072-023-06937-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/30/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVE To investigate the clinical and epidemiological characteristics of a large sample of patients with dementia due to Alzheimer's disease (AD) who were followed up at a cognitive neurology outpatient clinic. METHODS Retrospective, longitudinal, and descriptive design. We collected data from patients with dementia due to AD who visited the outpatient clinic of the SARAH Network of Rehabilitation Hospitals in Rio de Janeiro, Brazil, between May 2009 and June 2019. The evaluated characteristics included age of onset, sex, education, family history, comorbidities, time until diagnosis, and survival rates. RESULTS Overall, 1434 patients were evaluated, 74% of whom were women, with a mean age at symptom onset of 72.7 years and 75.8 at diagnosis. A positive family history was reported in 602 patients, with a first-degree relative in 86.3% of them. Hypertension was the most prevalent comorbidity, affecting 61.2% of the sample, and 16.2% were classified as having early-onset AD. The mean survival rate for the sample population was 112.8 months (9.4 years). The sample population was positively affected by dyslipidaemia. CONCLUSIONS This study presents a clinical and epidemiological analysis of a large and diverse group of patients with AD. The study confirms previous observations such as a higher prevalence of AD in women, low education among sufferers, and the presence of a family history. The study also found that comorbidities significantly affected patient survival and provides new data on the survival rates of patients with early and late AD in the Brazilian population.
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Affiliation(s)
- Elisa de Melo Queiroz
- SARAH Network of Rehabilitation Hospitals, Avenida Abelardo Bueno, 1500, Jacarepaguá, Rio de Janeiro, RJ, 22775-040, Brazil.
| | - Christian Marques Couto
- SARAH Network of Rehabilitation Hospitals, Avenida Abelardo Bueno, 1500, Jacarepaguá, Rio de Janeiro, RJ, 22775-040, Brazil
| | - Cláudio Antônio da Cruz Mecone
- SARAH Network of Rehabilitation Hospitals, Avenida Abelardo Bueno, 1500, Jacarepaguá, Rio de Janeiro, RJ, 22775-040, Brazil
| | - Waneska Souza Lima Macedo
- SARAH Network of Rehabilitation Hospitals, Avenida Abelardo Bueno, 1500, Jacarepaguá, Rio de Janeiro, RJ, 22775-040, Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research Group, Faculdade de Medicina, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 190 - Santa Efigênia, Belo Horizonte, 30130-100, Brazil
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12
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Franzen S, Nuytemans K, Bourdage R, Caramelli P, Ellajosyula R, Finger E, Illán-Gala I, Loi SM, Morhardt D, Pijnenburg Y, Rascovsky K, Williams MM, Yokoyama J, Alladi S, Broce I, Castro-Suarez S, Coleman K, de Souza LC, Dacks PA, de Boer SCM, de Leon J, Dodge S, Grasso S, Gupta V, Gupta V, Ghoshal N, Kamath V, Kumfor F, Matias-Guiu JA, Narme P, Nielsen TR, Okhuevbie D, Piña-Escudero SD, Garcia RR, Scarioni M, Slachevsky A, Suarez-Gonzalez A, Tee BL, Tsoy E, Ulugut H, Babulal GM, Onyike CU. Gaps in clinical research in frontotemporal dementia: A call for diversity and disparities-focused research. Alzheimers Dement 2023; 19:5817-5836. [PMID: 37270665 PMCID: PMC10693651 DOI: 10.1002/alz.13129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 02/06/2023] [Indexed: 06/05/2023]
Abstract
Frontotemporal dementia (FTD) is one of the leading causes of dementia before age 65 and often manifests as abnormal behavior (in behavioral variant FTD) or language impairment (in primary progressive aphasia). FTD's exact clinical presentation varies by culture, language, education, social norms, and other socioeconomic factors; current research and clinical practice, however, is mainly based on studies conducted in North America and Western Europe. Changes in diagnostic criteria and procedures as well as new or adapted cognitive tests are likely needed to take into consideration global diversity. This perspective paper by two professional interest areas of the Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment examines how increasing global diversity impacts the clinical presentation, screening, assessment, and diagnosis of FTD and its treatment and care. It subsequently provides recommendations to address immediate needs to advance global FTD research and clinical practice.
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Affiliation(s)
- Sanne Franzen
- Department of Neurology and Alzheimer Center, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Karen Nuytemans
- John P. Hussman Institute for Human Genomics and Dr. John T. Macdonald Department of Human Genetics, University of Miami, Miller School of Medicine, Miami, FL
| | - Renelle Bourdage
- Department of Neurology and Alzheimer Center, Erasmus MC University Medical Center, Rotterdam, the Netherlands
- Laboratoire Mémoire Cerveau et Cognition (UR 7536), Institut de Psychologie, Université Paris Cité, Boulogne-Billancourt, France
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research Group, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil
| | - Ratnavalli Ellajosyula
- Manipal Hospitals, Bangalore and Annasawmy Mudaliar Hospital, Bangalore, India
- Manipal Academy of Higher Education (MAHE), India
| | - Elizabeth Finger
- Parkwood Institute Research, London, Ontario, Canada
- Robarts Research Institute, University of Western Ontario, London, Ontario, Canada
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Ignacio Illán-Gala
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Samantha M. Loi
- Neuropsychiatry, Royal Melbourne Hospital, Parkville VIC Australia 3050
- Department of Psychiatry, University of Melbourne, Parkville VIC Australia 3052
| | - Darby Morhardt
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine
| | - Yolande Pijnenburg
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Katya Rascovsky
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania Perelman School of Medicine
| | | | - Jennifer Yokoyama
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Suvarna Alladi
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Iris Broce
- Department of Neurosciences, UC San Diego
- Department of Neurology, UC San Francisco
| | - Sheila Castro-Suarez
- CBI en Demencias y Enfermedades Desmielinizantes del Sistema Nervioso, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Atlantic Senior Fellow for Equity in Brain Health at the University of California San Francisco, San Francisco, CA, 94115, USA
| | | | - Leonardo Cruz de Souza
- Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Sterre C. M. de Boer
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Jessica de Leon
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, CA, USA
| | - Shana Dodge
- The Association for Frontotemporal Degeneration
| | - Stephanie Grasso
- Speech, Language and Hearing Sciences, The University of Texas at Austin
| | - Veer Gupta
- IMPACT—The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC 3216, Australia
| | - Vivek Gupta
- Macquarie Medical school, Faculty of Medicine, Health and Human Sciences, Macquarie University, NSW, Australia
| | - Nupur Ghoshal
- Depts. of Neurology and Psychiatry, Knight Alzheimer Disease Research Center, Washington University School of Medicine
| | - Vidyulata Kamath
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Fiona Kumfor
- The University of Sydney, Brain & Mind Centre and the School of Psychology, Sydney, Australia
| | - Jordi A. Matias-Guiu
- Department of Neurology, Hospital Clinico San Carlos, San Carlos Institute for Health Research (IdiSSC), Universidad Complutense, Madrid, Spain
| | - Pauline Narme
- Laboratoire Mémoire Cerveau et Cognition (UR 7536), Institut de Psychologie, Université Paris Cité, Boulogne-Billancourt, France
| | - T. Rune Nielsen
- Danish Dementia Research Center, Department of Neurology, The Neuroscience Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Daniel Okhuevbie
- Department of Cell Biology and Genetics, University of Lagos, Nigeria
- Department of Comparative Biosciences, University of Wisconsin-Madison, USA
| | - Stefanie D. Piña-Escudero
- Global Brain Health Institute at the Memory and Aging Center. University of California, San Francisco, USA
| | - Ramiro Ruiz Garcia
- Instituto Nacional de Neurología y Neurocirurgía Manuel Velasco Suárez, Mexico DF, Mexico
| | - Marta Scarioni
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Andrea Slachevsky
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department - Intitute of Biomedical Sciences (ICBM), Neurocience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
- Memory and Neuropsychiatric Center (CMYN), Memory Unit, Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
- Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Aida Suarez-Gonzalez
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Boon Lead Tee
- Memory and Aging Center, University of California at San Francisco, San Francisco, CA, United States
- Department of Neurology, Dyslexia Center, University of California, San Francisco, CA, United States
- Global Brain Health Institute, University of California, San Francisco, United States
| | - Elena Tsoy
- Speech, Language and Hearing Sciences, The University of Texas at Austin
- Global Brain Health Institute, University of California San Francisco and Trinity College Dublin
| | - Hülya Ulugut
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, CA, USA
| | - Ganesh M. Babulal
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
- Institute of Public Health, Washington University in St. Louis, St. Louis, MO, USA
- Department of Psychology, Faculty of Humanities, University of Johannesburg, South Africa
- Department of Clinical Research and Leadership, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Chiadi U. Onyike
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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13
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Martins MI, Cardoso FEC, Caramelli P, Mariano LI, Rocha NP, Jaeger A, Teixeira AL, Tumas V, Camargos ST, de Souza LC. Hearts and Minds: Emotion Recognition and Mentalizing in Parkinson's Disease and Progressive Supranuclear Palsy. Arch Clin Neuropsychol 2023:acad081. [PMID: 37856362 DOI: 10.1093/arclin/acad081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2023] [Indexed: 10/21/2023] Open
Abstract
OBJECTIVE There are scarce data comparing Parkinson's disease (PD) and Progressive Supranuclear Palsy (PSP) in social cognition (SC). We aimed to compare patients with PSP and PD in SC. METHODS We included three groups: PD (n = 18), PSP (n = 20) and controls (n = 23). Participants underwent neuropsychological exams, including the mini-version of the Social and Emotional Assessment, which is composed of the facial emotion recognition test (FERT) and the modified faux-pas (mFP) test, which assesses Theory of Mind (ToM). RESULTS Patients with PD scored lower than controls in the FERT, but not in the mFP test. Patients with PSP performed worse than controls in both the mFP and FERT. PD and PSP groups did not differ in the FERT, but PSP performed worse than PD in the mFP test. The mFP test distinguished PSP from PD with 89% accuracy. CONCLUSION The assessment of ToM may contribute to the differentiation between PD and PSP.
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Affiliation(s)
- Marina I Martins
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Francisco E C Cardoso
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
- Ambulatório de Distúrbios de Movimento da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
- Departamento de Clínica Médica da Faculdade de Medicina da UFMG, Belo Horizonte, MG, Brazil
| | - Paulo Caramelli
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
- Departamento de Clínica Médica da Faculdade de Medicina da UFMG, Belo Horizonte, MG, Brazil
- Grupo de Neurologia Cognitiva e do Comportamento da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Luciano I Mariano
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
- Grupo de Neurologia Cognitiva e do Comportamento da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Natalia P Rocha
- The Mitchell Center for Alzheimer's Disease and Related Brain Disorders, Department of Neurology, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Antônio Jaeger
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Antônio L Teixeira
- Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
- Santa Casa BH Ensino e Pesquisa, Avenida dos Andradas, 2.688, Santa Efigênia, Belo Horizonte, MG, Brazil
| | - Vítor Tumas
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Sarah T Camargos
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
- Ambulatório de Distúrbios de Movimento da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
- Departamento de Clínica Médica da Faculdade de Medicina da UFMG, Belo Horizonte, MG, Brazil
| | - Leonardo C de Souza
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
- Departamento de Clínica Médica da Faculdade de Medicina da UFMG, Belo Horizonte, MG, Brazil
- Grupo de Neurologia Cognitiva e do Comportamento da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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14
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Souza VSD, Guazzelli SB, Cruz LC, Resende EDPF, Souza LCD, Barbosa MT, Caramelli P. Diagnostic disclosure of Alzheimer's disease in Brazil: a national survey of specialized physicians. Arq Neuropsiquiatr 2023; 81:905-912. [PMID: 37939720 PMCID: PMC10631852 DOI: 10.1055/s-0043-1776316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/20/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND The diagnosis of Alzheimer's disease (AD) can bring financial and emotional consequences to patients and caregivers. Whether or not the diagnosis should be disclosed to patients is a matter of debate amongst physicians and can be influenced by culture and experience. OBJECTIVE To investigate the current practice of physicians who attend and treat patients with dementia in Brazil regarding the disclosure of dementia diagnosis and compare the practice with what has been performed 15 years ago in the country. METHODS Data were evaluated using an electronic questionnaire. The questions used to carry out this research were similar to the questions of the study carried out 15 years ago 9. The form was sent to the Brazilian Academy of Neurology, the Brazilian Association of Geriatrics and Gerontology, and the Brazilian Association of Psychiatry, which forwarded it to their members. Analyses were conducted through non-parametric statistical tests, with a post-hoc assessment. RESULTS 397 physicians responded to the survey, of which 231 are neurologists, 124 geriatricians, 29 psychiatrists and 13 from other specialties. The mean age was 45.2 years. The majority (66.7%) of the physicians reveal the diagnosis of AD always or usually. The youngest group of neurologists were more likely to disclose the diagnosis than the oldest group with a significant difference between them. In comparison to the 2008 Brazilian study, the percentage of physicians who always or usually disclose the diagnosis has risen by 22%. On the other hand, 12.3% of the physicians rarely or never disclose the diagnosis, in comparison to 25,3% in 2008. The main reasons for not disclosing the diagnosis concern the patients' mental health. CONCLUSION Advances in dementia knowledge and biomarkers availability probably explain the increase in the rate of disclosure. The main challenge is to reconcile the autonomy of affected individuals, mental health issues after the diagnosis and the family member's opinion.
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Affiliation(s)
- Vitor Santos de Souza
- Universidade Federal de Minas Gerais, Hospital das Clínicas, Belo Horizonte MG, Brazil.
| | | | - Leonardo Cardoso Cruz
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Belo Horizonte MG, Brazil.
| | - Elisa de Paula França Resende
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte MG, Brazil.
| | - Leonardo Cruz de Souza
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte MG, Brazil.
| | - Maira Tonidandel Barbosa
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte MG, Brazil.
| | - Paulo Caramelli
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte MG, Brazil.
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15
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Crivelli L, Calandri IL, Kimie Suemoto C, Salinas RM, Velilla LM, Yassuda MS, Caramelli P, Lopera F, Nitrini R, Sevlever GE, Sosa AL, Acosta D, Baietti AMC, Cusicanqui MI, Custodio N, De Simone SD, Derio CD, Duque-Peñailillo L, Duran JC, Jiménez-Velázquez IZ, Leon-Salas JM, Bergamo Y, Clarens MF, Damian A, Demey I, Helou MB, Márquez C, Martin ME, Martin MDGM, Querze D, Surace EI, Acosta-Egea S, Aguirre-Salvador E, de Souza LC, Cançado GHDCP, Brucki SMD, Friedlaender CV, Gomes KB, Gutierrez M, Ríos CL, Galindo JGM, Montesinos R, Nuñez-Herrera A, Ospina-Henao S, Rodríguez G, Masson VR, Sánchez M, Schenk CE, Soto L, Barbosa MT, Tosatti JAG, Vicuña Y, Espeland M, Hakansson K, Kivipelto M, Baker L, Snyder H, Carrillo M, Allegri RF. Latin American Initiative for Lifestyle Intervention to Prevent Cognitive Decline (LatAm-FINGERS): Study design and harmonization. Alzheimers Dement 2023; 19:4046-4060. [PMID: 37204054 PMCID: PMC11021182 DOI: 10.1002/alz.13101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/02/2023] [Accepted: 03/08/2023] [Indexed: 05/20/2023]
Abstract
INTRODUCTION Latin American Initiative for Lifestyle Intervention to Prevent Cognitive Decline (LatAm-FINGERS) is the first non-pharmacological multicenter randomized clinical trial (RCT) to prevent cognitive impairment in Latin America (LA). Our aim is to present the study design and discuss the strategies used for multicultural harmonization. METHODS This 1-year RCT (working on a 1-year extension) investigates the feasibility of a multi-domain lifestyle intervention in LA and the efficacy of the intervention, primarily on cognitive function. An external harmonization process was carried out to follow the FINGER model, and an internal harmonization was performed to ensure this study was feasible and comparable across the 12 participating LA countries. RESULTS Currently, 1549 participants have been screened, and 815 randomized. Participants are ethnically diverse (56% are Nestizo) and have high cardiovascular risk (39% have metabolic syndrome). DISCUSSION LatAm-FINGERS overcame a significant challenge to combine the region's diversity into a multi-domain risk reduction intervention feasible across LA while preserving the original FINGER design.
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Affiliation(s)
- Lucia Crivelli
- Department of Cognitive Neurology, Fleni, Buenos Aires, Argentina
| | | | | | - Rosa María Salinas
- Laboratorio de Demencias del Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Ciudad de México, México
| | - Lina Marcela Velilla
- Neuroscience Group of Antioquia Medical School, Antioquia University, Medellín, Colombia
| | - Mônica Sanches Yassuda
- Cognitive and Behavioral Neurology Unit, Department of Neurology, University of Såo Paulo School of Medicine, Såo Paulo, Brazil
- Gerontology, School of Arts, Sciences, and Humanities, University of Såo Paulo, Såo Paulo, Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Francisco Lopera
- Neuroscience Group of Antioquia Medical School, Antioquia University, Medellín, Colombia
| | - Ricardo Nitrini
- Cognitive and Behavioral Neurology Unit, Department of Neurology, University of Såo Paulo School of Medicine, Såo Paulo, Brazil
| | | | - Ana Luisa Sosa
- Laboratorio de Demencias del Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Ciudad de México, México
| | - Daisy Acosta
- Internal Medicine Department, Universidad Nacional Pedro Henriquez Urena (UNPHU), Santo Domingo, Dominican Republic
| | - Ana María Charamelo Baietti
- Clínica de la Memoria-Hospital Británico, Montevideo, Uruguay
- Departamento de Neuropsicología, Facultad de Medicina-Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
| | | | - Nilton Custodio
- Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia, Instituto Peruano de Neurociencias, Lima, Perú
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Perú
| | - Sergio Dansilio De Simone
- Departamento de Neuropsicología, Facultad de Medicina-Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
| | - Carolina Delgado Derio
- Unidad de Cerebro Saludable, Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Santiago de Chile, Chile
| | | | | | - Ivonne Z. Jiménez-Velázquez
- Centro de Investigación en Geriatría, Departamento de Medicina Interna, Recinto de Ciencias Médicas, Universidad de Puerto Rico, San Juan, Puerto Rico
| | - Jorge Mario Leon-Salas
- Departamento de Investigación Clínica, Life Science Research Institute, Hospital Clínica Bíblica, San José, Costa Rica
| | - Yanina Bergamo
- Department of Diagnostic Imaging, Fleni, Buenos Aires, Argentina
| | | | - Andrés Damian
- CUDIM Centro Uruguayo de Imagenología Molecular, Montevideo, Uruguay
| | - Ignacio Demey
- Department of Cognitive Neurology, Fleni, Buenos Aires, Argentina
| | | | - Carlos Márquez
- Instituto de Nutricion y Tecnología de los Alimentos, Universidad de Chile, Santiago de Chile, Chile
| | | | | | - Diego Querze
- Department of Neurology, Fleni, Buenos Aires, Argentina
| | | | - Sabrina Acosta-Egea
- Departamento de Investigación Clínica, Life Science Research Institute, Hospital Clínica Bíblica, San José, Costa Rica
| | | | - Leonardo Cruz de Souza
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Sonia Maria Dozzi Brucki
- Cognitive and Behavioral Neurology Unit, Department of Neurology, University of Såo Paulo School of Medicine, Såo Paulo, Brazil
| | | | - Karina Braga Gomes
- Faculdade de Farmícia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Myriam Gutierrez
- Unidad de Cerebro Saludable, Departamento de Neurociencia, Facultad de Medicina, Universidad de Chile, Santiago de Chile, Chile
| | | | - Joyce Graciela Martinez Galindo
- Laboratorio de Demencias del Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Ciudad de México, México
| | - Rosa Montesinos
- Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia, Instituto Peruano de Neurociencias, Lima, Perú
| | | | - Sebastián Ospina-Henao
- Facultad de Medicina, Universidad de Ciencias Médicas, Instituto de Investigación en Ciencias Médicas, San José, Costa Rica
| | - Guillermina Rodríguez
- Department of Demography and Biostatistics, Ministry of Public Health, Santo Domingo, Dominican Republic
| | | | - Mónica Sánchez
- Cognitive Disorders Unit–Neuromedicenter, Quito, Ecuador
| | - Christian E. Schenk
- Neurology Division, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Ligia Soto
- Cognitive Disorders Unit–Neuromedicenter, Quito, Ecuador
| | - Maira Tonidandel Barbosa
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Jéssica Abdo Gonçalves Tosatti
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Yosselin Vicuña
- Inbiomed (Instituto de Investigacion en Biomedicina), Universidad Central del Ecuador, Quito, Ecuador
| | - Mark Espeland
- Departments of Internal Medicine and Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Krister Hakansson
- Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Centre for Alzheimer Research, Karolinska Institutet and Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
| | - Laura Baker
- Departments of Internal Medicine, Neurology, and Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | | | | | - Ricardo Francisco Allegri
- Department of Cognitive Neurology, Fleni, Buenos Aires, Argentina
- Department of Neurosciences, Universidad de la Costa (CUC), Barranquilla, Colombia
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16
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Ferreira NV, Bertola L, Santos IS, Goulart AC, Bittencourt MS, Barreto SM, Giatti L, Caramelli P, Pereira A, Lotufo PA, Bensenor IM, Suemoto CK. Association between carotid intima-media thickness and cognitive decline differs by race. Alzheimers Dement 2023; 19:3528-3536. [PMID: 36825689 DOI: 10.1002/alz.12996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
INTRODUCTION Common carotid intima-media thickness (cIMT) is a marker of subclinical atherosclerosis and is associated with cognitive decline. Although carotid atherosclerosis is more frequent in White than in Black participants, little is known whether race modifies the association between cIMT and cognitive decline. METHODS In this longitudinal analysis of the ELSA-Brasil, we assessed cIMT using ultrasound and cognitive performance using different domain tests. We used linear mixed models, interaction analysis, and race stratified analyses. RESULTS Baseline high IMT values were associated with memory (p < 0.001), verbal fluency (p < 0.001), TMT-B (p < 0.001)), and global cognitive decline (p < 0.001). Race was an effect modifier in the association between IMT and global cognitive decline (0.043), with stronger association in White (p < 0.001) than in Black (p = 0.009) participants. DISCUSSION Baseline IMT was associated with global and domain-specific cognitive decline and race modified this relationship, with stronger associations in White participants. HIGHLIGHTS Carotid intima-media thickness (cIMT) was associated with cognitive decline. cIMT and cognitive decline association was stronger in White than in Black participants. We used inverse probability weighting to address attrition bias.
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Affiliation(s)
- Naomi Vidal Ferreira
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
- Adventist University of Sao Paulo, Engenheiro Coelho, Sao Paulo, Brazil
- Amazonia Adventist College, Benevides, Pará, Brazil
| | - Laiss Bertola
- Department of Psychiatry, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Itamar S Santos
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
- Department of Internal Medicine, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Alessandra C Goulart
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Marcio S Bittencourt
- Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Sandhi Maria Barreto
- Departamento de Medicina Preventiva e Social, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Luana Giatti
- School of Medicine and Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Alexandre Pereira
- Heart Institute, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Paulo Andrade Lotufo
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
- Department of Internal Medicine, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Isabela M Bensenor
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
- Department of Internal Medicine, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Claudia Kimie Suemoto
- Division of Geriatrics, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Sao Paulo, Brazil
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Caramelli P. Pain in older adults with dementia: improving diagnosis to provide better care. Arq Neuropsiquiatr 2023; 81:705-706. [PMID: 37647903 PMCID: PMC10468231 DOI: 10.1055/s-0043-1772671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 09/01/2023]
Affiliation(s)
- Paulo Caramelli
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Unidade de Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brazil
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18
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Vale TC, Cardoso FEC, da Silva DJ, Resende EDPF, Maia DP, Cunningham MCQ, Guimarães HC, Machado JCB, Teixeira AL, Caramelli P, Barbosa MT. Clinical and functional correlates of parkinsonism in a population-based sample of individuals aged 75 + : the Pietà study. BMC Neurol 2023; 23:276. [PMID: 37479964 PMCID: PMC10360246 DOI: 10.1186/s12883-023-03290-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 06/16/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Parkinsonism is strongly associated with ageing, and many studies have suggested that parkinsonian signs may affect up to half of older adults and is associated with a wide range of adverse health outcomes. We compared clinical and functional characteristics of oldest-old community-dwelling individuals with parkinsonism (parkinsonian group [PG]) to individuals without parkinsonism (non-parkinsonian group [NPG]. METHODS The Pietà study is a population-based study conducted in Caeté, southeast Brazil, involving 607 individuals aged 75 + years submitted to an extensive clinical evaluation. A subset of 65 PG individuals (61.5% women, median age of 82 years) was compared to 542 NPG individuals (64.8% women, median age of 80 years). RESULTS PG individuals had significantly more functional impairment, clinical comorbidities (including number of falls, loss of bladder control and dysphagia) and major depression. Multivariate analysis revealed that older age, higher UPDRSm scores, lower category fluency test (animals/minute) and delayed recall memory scores were associated with PG. This group was also more cognitively impaired, with lower performance than NPG individuals in the Mini-Mental State Examination, category fluency test (animals/minute), clock drawing and in delayed recall (p < 0.001 for all tests). UPDRSm scores were the most contributing factor to cognition that independently explained variability in functionality of the entire sample. CONCLUSION Individuals aged 75 + years with parkinsonism were significantly more clinically and functionally impaired in this population-based sample. Cognitive dysfunction explained most of the loss of functionality in these patients. UPDRS-m scores contributed independently to explain variability in functionality in the whole sample.
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Affiliation(s)
- Thiago Cardoso Vale
- Internal Medicine Department, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
- Movement Disorders Unit, Hospital Universitário, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
| | - Francisco Eduardo Costa Cardoso
- Movement Disorders Unit, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Danilo Jorge da Silva
- Internal Medicine Department, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Elisa de Paula Franca Resende
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - Débora Palma Maia
- Movement Disorders Unit, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Henrique Cerqueira Guimarães
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Antônio Lúcio Teixeira
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Maira Tonidandel Barbosa
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
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19
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Lopera F, Custodio N, Rico-Restrepo M, Allegri RF, Barrientos JD, Garcia Batres E, Calandri IL, Calero Moscoso C, Caramelli P, Duran Quiroz JC, Jansen AM, Mimenza Alvarado AJ, Nitrini R, Parodi JF, Ramos C, Slachevsky A, Brucki SMD. A task force for diagnosis and treatment of people with Alzheimer's disease in Latin America. Front Neurol 2023; 14:1198869. [PMID: 37497015 PMCID: PMC10367107 DOI: 10.3389/fneur.2023.1198869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 06/21/2023] [Indexed: 07/28/2023] Open
Abstract
Alzheimer's disease (AD) represents a substantial burden to patients, their caregivers, health systems, and society in Latin America and the Caribbean (LAC). This impact is exacerbated by limited access to diagnosis, specialized care, and therapies for AD within and among nations. The region has varied geographic, ethnic, cultural, and economic conditions, which create unique challenges to AD diagnosis and management. To address these issues, the Americas Health Foundation convened a panel of eight neurologists, geriatricians, and psychiatrists from Argentina, Brazil, Colombia, Ecuador, Guatemala, Mexico, and Peru who are experts in AD for a three-day virtual meeting to discuss best practices for AD diagnosis and treatment in LAC and create a manuscript offering recommendations to address identified barriers. In LAC, several barriers hamper diagnosing and treating people with dementia. These barriers include access to healthcare, fragmented healthcare systems, limited research funding, unstandardized diagnosis and treatment, genetic heterogeneity, and varying social determinants of health. Additional training for physicians and other healthcare workers at the primary care level, region-specific or adequately adapted cognitive tests, increased public healthcare insurance coverage of testing and treatment, and dedicated search strategies to detect populations with gene variants associated with AD are among the recommendations to improve the landscape of AD.
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Affiliation(s)
- Francisco Lopera
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - Nilton Custodio
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
| | | | - Ricardo F. Allegri
- Department of Cognitive Neurology, Instituto Neurológico Fleni, Buenos Aires, Argentina
| | | | - Estuardo Garcia Batres
- Geriatric Unit, New Hope, Interior Hospital Atención Medica Siloé, Ciudad de Guatemala, Guatemala
| | - Ismael L. Calandri
- Department of Cognitive Neurology, Instituto Neurológico Fleni, Buenos Aires, Argentina
| | - Cristian Calero Moscoso
- Department of Neurology, HCAM Memory and Behavior Unit, University of Hospital Carlos Andrade Marin HCAM, Quito, Ecuador
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research Group, Faculty of Medicine, University of Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Juan Carlos Duran Quiroz
- Faculty of Medicine, Department of Functional Sciences, Physiology Division, Universidad Mayor de San Andres, La Paz, Bolivia
| | | | - Alberto José Mimenza Alvarado
- Memory Disorders Clinic, Neurological Geriatrics Program, Department of Geriatrics, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - Ricardo Nitrini
- Cognitive and Behavioral Neurology Group, Department of Neurology, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Jose F. Parodi
- Centro de Investigación del Envejecimiento, Facultad de Medicina, Universidad de San Martín de Porres, Lima, Peru
| | - Claudia Ramos
- Antioquia Neurosciences Group, University of Antioquia, Medellin, Colombia
| | - Andrea Slachevsky
- Geroscience Center for Brain Health and Metabolism (GERO), University of Chile, Santiago, Chile
| | - Sonia María Dozzi Brucki
- Cognitive and Behavioral Neurology Group, Department of Neurology, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
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Simon SS, Brucki SMD, Fonseca LM, Becker J, Cappi C, Marques AH, Heyn PC, Gonçalves PD, Martins SS, Busatto G, Bertola L, Suemoto CK, Nitrini R, Caramelli P, Yassuda MS, Miotto EC, Grinberg LT, Arce Renteria M, Alegria M, Stern Y, Rivera‐Mindt M. The (in)visible Brazilians: A perspective review on the need for brain health and dementia research with Brazilian immigrants in the United States. Alzheimers Dement (N Y) 2023; 9:e12425. [PMID: 37744309 PMCID: PMC10517444 DOI: 10.1002/trc2.12425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/23/2023] [Accepted: 08/26/2023] [Indexed: 09/26/2023]
Abstract
Introduction The Brazilian population in the United States (U.S.), a Latinx subgroup, is rapidly growing and aging but remains underrepresented in U.S. health research. In addition to group-specific genetic and environmental risks, Brazilian immigrants and their offspring in the U.S. likely have cumulative risks for health inequities.It is estimated that 71% of Brazilian immigrants in the U.S. are undocumented, which may limit healthcare access/utilization. Furthermore, mental health is reported as a health priority by Brazilian immigrants in the U.S., and there is a lack of research on Alzheimer's disease and related dementia (AD/ADRD) in this population. Methods We reviewed the scientific literature using traditional (e.g., PubMed) sources and databases generated by U.S. and Brazilian governments, as well as international organizations, and press articles. Results This perspective review lists recommendations for researchers, health providers, and policymakers to promote greater inclusion of U.S. Brazilian populations in health research and care. The review identifies research areas in need of attention to address health inequities and promote mental/brain health in Brazilian immigrants and their offspring living in the U.S. These research areas are: 1) epidemiological studies to map the prevalence and incidence of mental/brain health conditions; 2) research on aging and AD/ADRD risk factors among Brazilian populations in the U.S.; and 3) the need for greater representation of U.S-residing Brazilian population in other relevant research areas involving genetics, neuropathology, and clinical trials. Conclusions The recommendation and research efforts proposed should help to pave the way for the development of community-engagement research and to promote mental/brain health education, improvement of mental/brain health and AD/ADRD services, and the development of culturally-informed intervention to the U.S.-residing Brazilian communities. HIGHLIGHTS The Brazilian population in the United States is growing but is underrepresented in U.S. health research.Approximately 71% of Brazilian immigrants in the United States are undocumented, with an increased risk for health inequities.Mental health is reported as a central health priority by Brazilian immigrants in the United States.There is a lack of research on Alzheimer's disease and other dementias (ADRD) in Brazilian immigrants in the United States.Epidemiological research is needed to map the prevalence/incidence of mental health conditions and ADRD risk factors among Brazilian immigrants in the United States.
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Affiliation(s)
- Sharon Sanz Simon
- Cognitive Neuroscience DivisionDepartment of NeurologyColumbia UniversityVagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of NeurologyColumbia UniversityVagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
- Old Age Research Group, Department of PsychiatryUniversity of São Paulo Medical SchoolSão PauloSão PauloBrazil
| | | | - Luciana Mascarenhas Fonseca
- Old Age Research Group, Department of PsychiatryUniversity of São Paulo Medical SchoolSão PauloSão PauloBrazil
- Department of Community and Behavioral HealthElson S. Floyd College of MedicineWashington State UniversitySpokaneWashingtonUSA
| | - Jacqueline Becker
- Division of General Internal MedicineIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Carolina Cappi
- Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Seaver Autism Center for Research and TreatmentIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Department of PsychiatryClinics HospitalUniversity of São PauloSchool of MedicineSão PauloSão PauloBrazil
| | - Andrea Horvath Marques
- Elliott School International AffairsThe George Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Patricia C. Heyn
- Center for Optimal AgingDepartment of Physical TherapyMarymount UniversityArlingtonVirginiaUSA
| | - Priscila Dib Gonçalves
- Department of EpidemiologyColumbia University Mailman School of Public HealthNew YorkNew YorkUSA
| | - Silvia S. Martins
- Department of EpidemiologyColumbia University Mailman School of Public HealthNew YorkNew YorkUSA
| | - Geraldo Busatto
- Laboratory of Psychiatric Neuroimaging (LIM‐21)Department of PsychiatryUniversity of São Paulo Medical SchoolSão PauloSão PauloBrazil
| | - Laiss Bertola
- Department of PsychiatryEscola Paulista de Medicina, Universidade Federal de São PauloSão PauloBrazil
| | - Claudia Kimie Suemoto
- Division of GeriatricsDepartment of Clinical MedicineUniversity of São Paulo Medical SchoolSão PauloSão PauloBrazil
| | - Ricardo Nitrini
- Old Age Research Group, Department of PsychiatryUniversity of São Paulo Medical SchoolSão PauloSão PauloBrazil
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research GroupFaculdade de MedicinaUniversidade Federal de Minas GeraisBelo HorizonteMinas GeraisBrazil
| | - Monica Sanches Yassuda
- Department of NeurologyUniversity of São Paulo Medical SchoolSão PauloSão PauloBrazil
- Gerontology, School of Arts, Sciences, and HumanitiesUniversity of São PauloSão PauloSão PauloBrazil
| | - Eliane Correa Miotto
- Old Age Research Group, Department of PsychiatryUniversity of São Paulo Medical SchoolSão PauloSão PauloBrazil
| | - Lea Tenenholz Grinberg
- Memory and Aging CenterDepartment of NeurologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
- Department of PathologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
- LIM‐22Department of PathologyUniversity of São Paulo Medical SchoolSão PauloSão PauloBrazil
- Global Brain Health InstituteUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Miguel Arce Renteria
- Cognitive Neuroscience DivisionDepartment of NeurologyColumbia UniversityVagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of NeurologyColumbia UniversityVagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
| | - Margarita Alegria
- Disparities Research UnitDepartment of MedicineMassachusetts General HospitalBostonMassachusettsUSA
- Department of MedicineHarvard Medical SchoolBostonMassachusettsUSA
- Department of PsychiatryHarvard Medical SchoolBostonMassachusettsUSA
| | - Yaakov Stern
- Cognitive Neuroscience DivisionDepartment of NeurologyColumbia UniversityVagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of NeurologyColumbia UniversityVagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
| | - Monica Rivera‐Mindt
- Department of PsychologyFordham UniversityNew YorkNew YorkUSA
- Department of NeurologyIcahn School of MedicineNew YorkNew YorkUSA
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21
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Souza LCD, Brucki SMD, Schilling LP, Silva LCD, Takada LT, Bahia VS, Barbosa BJAP, Balthazar MLF, Frota NAF, Nitrini R, Caramelli P, Smid J. Current clinical and research practices on frontotemporal dementia in Brazil: a national survey. Arq Neuropsiquiatr 2023; 81:632-640. [PMID: 37494948 PMCID: PMC10658665 DOI: 10.1055/s-0043-1771173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/03/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND Frontotemporal dementia (FTD) is a frequent cause of young-onset dementia and represents a major challenge for the diagnosis and clinical management. It is essential to evaluate the difficulties faced by physicians on the diagnostic workup and on patient care. OBJECTIVE The aim of this study was to investigate the current practices and the local limits on the diagnosis and management of FTD in Brazil. METHODS We elaborated an online survey, composed of 29 questions and divided in four parts, comprising questions about existing health facilities, clinical practices related to FTD, and suggestions to increment the national research on FTD. The invitation to participate was sent by email to all neurologists affiliated to the Brazilian Academy of Neurology (n = 3658), and to all physicians who attended the XII Meeting of Researchers on Alzheimer's disease, in 2019 (n = 187). The invitation was also diffused through social media. RESULTS 256 Brazilian physicians answered the questionnaire. The three most relevant disorders for the differential diagnosis of FTD were Alzheimer's disease (AD) (n = 211), bipolar disorder (n = 117) and dementia with Lewy bodies (n = 92). Most respondents (125/256) reported the difficulty in performing genetic testing as the main limit in the diagnostic of FTD. 93% and 63% of participants considered that the assessment of social cognition and AD CSF biomarkers are useful for the diagnosis of FTD, respectively. CONCLUSIONS The present study may provide valuable insights for the medical education and clinical training of physicians, and to foster future research on FTD in Brazil.
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Affiliation(s)
- Leonardo Cruz de Souza
- Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Belo
Horizonte MG, Brazil.
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de
Clínica Médica, Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Belo
Horizonte MG, Brazil.
| | - Sonia Maria Dozzi Brucki
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia,
Grupo de Neurologia Cognitiva e do Comportamento, São Paulo SP, Brazil.
| | - Lucas Porcello Schilling
- Pontifícia Universidade do Rio Grande do Sul, Escola de Medicina, Serviço de
Neurologia, Porto Alegre RS, Brazil.
- Pontifícia Universidade do Rio Grande do Sul, Instituto do Cérebro do Rio
Grande do Sul, Porto Alegre RS, Brazil.
- Pontifícia Universidade do Rio Grande do Sul, Programa de Pós-Graduação em
Gerontologia Biomédica, Porto Alegre RS, Brazil.
| | - Letícia Costa da Silva
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de
Clínica Médica, Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Belo
Horizonte MG, Brazil.
| | - Leonel Tadao Takada
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia,
Grupo de Neurologia Cognitiva e do Comportamento, São Paulo SP, Brazil.
| | | | - Breno José Alencar Pires Barbosa
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia,
Grupo de Neurologia Cognitiva e do Comportamento, São Paulo SP, Brazil.
- Universidade Federal de Pernambuco, Centro de Ciências Médicas, Área Acadêmica
de Neuropsiquiatria, Recife PE, Brazil.
| | | | - Norberto Anizio Ferreira Frota
- Hospital Geral de Fortaleza, Serviço de Neurologia, Fortaleza CE,
Brazil.
- Universidade de Fortaleza (UNIFOR), Fortaleza CE, Brazil.
| | - Ricardo Nitrini
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia,
Grupo de Neurologia Cognitiva e do Comportamento, São Paulo SP, Brazil.
| | - Paulo Caramelli
- Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Belo
Horizonte MG, Brazil.
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de
Clínica Médica, Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Belo
Horizonte MG, Brazil.
| | - Jerusa Smid
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia,
Grupo de Neurologia Cognitiva e do Comportamento, São Paulo SP, Brazil.
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de Paula França Resende E, Lara VP, Santiago ALC, Friedlaender CV, Rosen HJ, Brown JA, Cobigo Y, Silva LLG, de Souza LC, Rincon L, Grinberg LT, Maciel FIP, Caramelli P. Literacy, but not memory, is associated with hippocampal connectivity in illiterate adults. Res Sq 2023:rs.3.rs-3053775. [PMID: 37398238 PMCID: PMC10312990 DOI: 10.21203/rs.3.rs-3053775/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Background The influence of hippocampal connectivity on memory performance is well established in individuals with high educational attainment. However, the role of hippocampal connectivity in illiterate populations remains poorly understood. Methods Thirty-five illiterate adults were administered a literacy assessment (Test of Functional Health Literacy in Adults - TOFHLA), structural and resting state functional MRI and an episodic memory test (Free and Cued Selective Reminding Test). Illiteracy was defined as a TOFHLA score below 53. We evaluated the correlation between hippocampal connectivity at rest and both free recall and literacy scores. Results Participants were mostly female (57.1%) and Black (84.8%), with a median age of 50 years. The median TOFHLA literacy score was 28.0 [21.0;42.5] out of 100 points and the median free recall score was 30.0 [26.2;35] out of 48 points. The median gray matter volume of both the left and right hippocampi was 2.3 [2.1; 2.4] cm3. We observed a significant connectivity between both hippocampi and the precuneus and the ventral medial prefrontal cortex. Interestingly, the right hippocampal connectivity positively correlated with the literacy scores (β = 0.58, p = 0.008). There was no significant association between episodic memory and hippocampal connectivity. Neither memory nor literacy scores correlated with hippocampal gray matter volume. Conclusions Low literacy levels correlate with hippocampal connectivity in illiterate adults. The lack of association with memory scores might be associated with low brain reserve in illiterate adults.
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Gomes KB, Pereira RG, Braga AA, Guimarães HC, Resende EDPF, Teixeira AL, Barbosa MT, Junior WM, Carvalho MDG, Caramelli P. Machine Learning-Based Routine Laboratory Tests Predict One-Year Cognitive and Functional Decline in a Population Aged 75+ Years. Brain Sci 2023; 13:brainsci13040690. [PMID: 37190655 DOI: 10.3390/brainsci13040690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/30/2023] [Accepted: 04/15/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Cognitive and functional decline are common problems in older adults, especially in those 75+ years old. Currently, there is no specific plasma biomarker able to predict this decline in healthy old-age people. Machine learning (ML) is a subarea of artificial intelligence (AI), which can be used to predict outcomes Aim: This study aimed to evaluate routine laboratory variables able to predict cognitive and functional impairment, using ML algorithms, in a cohort aged 75+ years, in a one-year follow-up study. METHOD One hundred and thirty-two older adults aged 75+ years were selected through a community-health public program or from long-term-care institutions. Their functional and cognitive performances were evaluated at baseline and one year later using a functional activities questionnaire, Mini-Mental State Examination, and the Brief Cognitive Screening Battery. Routine laboratory tests were performed at baseline. ML algorithms-random forest, support vector machine (SVM), and XGBoost-were applied in order to describe the best model able to predict cognitive and functional decline using routine tests as features. RESULTS The random forest model showed better accuracy than other algorithms and included triglycerides, glucose, hematocrit, red cell distribution width (RDW), albumin, hemoglobin, globulin, high-density lipoprotein cholesterol (HDL-c), thyroid-stimulating hormone (TSH), creatinine, lymphocyte, erythrocyte, platelet/leucocyte (PLR), and neutrophil/leucocyte (NLR) ratios, and alanine transaminase (ALT), leukocyte, low-density lipoprotein cholesterol (LDL-c), cortisol, gamma-glutamyl transferase (GGT), and eosinophil as features to predict cognitive decline (accuracy = 0.79). For functional decline, the most important features were platelet, PLR and NLR, hemoglobin, globulin, cortisol, RDW, glucose, basophil, B12 vitamin, creatinine, GGT, ALT, aspartate transferase (AST), eosinophil, hematocrit, erythrocyte, triglycerides, HDL-c, and monocyte (accuracy = 0.92). CONCLUSIONS Routine laboratory variables could be applied to predict cognitive and functional decline in oldest-old populations using ML algorithms.
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Affiliation(s)
- Karina Braga Gomes
- Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Ramon Gonçalves Pereira
- Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Alexandre Alberto Braga
- Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | | | | | | | - Maira Tonidandel Barbosa
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Wagner Meira Junior
- Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | | | - Paulo Caramelli
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
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24
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Barbosa IG, Leite FDMC, Bertoux M, Guimarães HC, Mariano LI, Gambogi LB, Teixeira AL, Caramelli P, de Souza LC. Social cognition across bipolar disorder and behavioral variant frontotemporal dementia: an exploratory study. Braz J Psychiatry 2023; 45:132-136. [PMID: 36749822 PMCID: PMC10154010 DOI: 10.47626/1516-4446-2022-2935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/03/2023] [Indexed: 02/09/2023]
Abstract
OBJECTIVES Bipolar Disorder type 1 (BD1) and behavioral variant frontotemporal dementia (bvFTD) share similar behavioral and cognitive symptoms, rendering the differential diagnosis between them a clinical challenge. We investigated the accuracy of social cognition measures to differentiate bvFTD from BD. METHODS We included three groups of participants: early-onset BD1 (in remission, n = 20), bvFTD (n = 18), and cognitively healthy controls (HC, n = 40), matched for age, schooling, and sex. All participants underwent cognitive assessment including the facial emotion recognition (FER) and the modified faux-pas tests, which assess mentalizing. RESULTS Compared to HC, BD1, and bvFTD patients underperformed on both social cognition measures. BD1 and bvFTD did not differ on the FER's or faux pas tests' total score, although bvFTD patients had significantly higher difficulties than BD1 to detect social faux-pas (p < 0.001, d = 1.35). CONCLUSIONS BD1 and bvFTD share deficits in the core social cognition functions. These findings should be considered in the development of tasks aiming to improve the clinical differentiation between both disorders.
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Affiliation(s)
- Izabela Guimarães Barbosa
- Departamento de Saúde Mental, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil. Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Flávia da Mata Chiácchio Leite
- Serviço de Psiquiatria - Instituto da Previdência dos Servidores do Estado de Minas Gerais (IPSEMG), Belo Horizonte, MG, Brazil
| | - Maxime Bertoux
- Univ. Lille, Inserm, Lille Neuroscience & Cognition, Lille, France. Lille Centre of Excellence for Neurodegenerative Disorders & Development of Innovative Strategies for a Transdisciplinary approach to ALZheimer's disease lab, Lille, France
| | - Henrique Cerqueira Guimarães
- Grupo de Neurologia Cognitiva e do Comportamento, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Luciano Inácio Mariano
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil. Grupo de Neurologia Cognitiva e do Comportamento, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Leandro Boson Gambogi
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil. Grupo de Neurologia Cognitiva e do Comportamento, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Antônio Lúcio Teixeira
- Santa Casa BH Ensino e Pesquisa, Belo Horizonte, MG, Brazil. Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Paulo Caramelli
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil. Grupo de Neurologia Cognitiva e do Comportamento, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil. Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Leonardo Cruz de Souza
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil. Grupo de Neurologia Cognitiva e do Comportamento, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil. Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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25
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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26
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Gomes Gonçalves N, Vidal Ferreira N, Khandpur N, Martinez Steele E, Bertazzi Levy R, Andrade Lotufo P, Bensenor IM, Caramelli P, Alvim de Matos SM, Marchioni DM, Suemoto CK. Association Between Consumption of Ultraprocessed Foods and Cognitive Decline. JAMA Neurol 2023; 80:142-150. [PMID: 36469335 PMCID: PMC9857155 DOI: 10.1001/jamaneurol.2022.4397] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 10/07/2022] [Indexed: 12/12/2022]
Abstract
Importance Although consumption of ultraprocessed food has been linked to higher risk of cardiovascular disease, metabolic syndrome, and obesity, little is known about the association of consumption of ultraprocessed foods with cognitive decline. Objective To investigate the association between ultraprocessed food consumption and cognitive decline in the Brazilian Longitudinal Study of Adult Health. Design, Setting, and Participants This was a multicenter, prospective cohort study with 3 waves, approximately 4 years apart, from 2008 to 2017. Data were analyzed from December 2021 to May 2022. Participants were public servants aged 35 to 74 years old recruited in 6 Brazilian cities. Participants who, at baseline, had incomplete food frequency questionnaire, cognitive, or covariate data were excluded. Participants who reported extreme calorie intake (<600 kcal/day or >6000 kcal/day) and those taking medication that could negatively interfere with cognitive performance were also excluded. Exposures Daily ultraprocessed food consumption as a percentage of total energy divided into quartiles. Main Outcomes and Measures Changes in cognitive performance over time evaluated by the immediate and delayed word recall, word recognition, phonemic and semantic verbal fluency tests, and Trail-Making Test B version. Results A total of 15 105 individuals were recruited and 4330 were excluded, leaving 10 775 participants whose data were analyzed. The mean (SD) age at the baseline was 51.6 (8.9) years, 5880 participants (54.6%) were women, 5723 (53.1%) were White, and 6106 (56.6%) had at least a college degree. During a median (range) follow-up of 8 (6-10) years, individuals with ultraprocessed food consumption above the first quartile showed a 28% faster rate of global cognitive decline (β = -0.004; 95% CI, -0.006 to -0.001; P = .003) and a 25% faster rate of executive function decline (β = -0.003, 95% CI, -0.005 to 0.000; P = .01) compared with those in the first quartile. Conclusions and Relevance A higher percentage of daily energy consumption of ultraprocessed foods was associated with cognitive decline among adults from an ethnically diverse sample. These findings support current public health recommendations on limiting ultraprocessed food consumption because of their potential harm to cognitive function.
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Affiliation(s)
| | - Naomi Vidal Ferreira
- Adventist University of São Paulo, Engenheiro Coelho, Brazil
- Division of Geriatrics, University of São Paulo Medical School, São Paulo, Brazil
| | - Neha Khandpur
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | - Renata Bertazzi Levy
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Paulo Andrade Lotufo
- Center for Clinical and Epidemiological Research, Hospital Universitário, University of São Paulo, São Paulo, Brazil
| | - Isabela M. Bensenor
- Center for Clinical and Epidemiological Research, Hospital Universitário, University of São Paulo, São Paulo, Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Dirce M. Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
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Carmona KC, Resende EDPF, Guimarães HC, Machado TH, Amaral-Carvalho V, Santos ELD, Barbosa MT, Caramelli P. High performance older adults in a population-based sample with low education: Pietà study. Arq Neuropsiquiatr 2023; 81:112-118. [PMID: 36948197 PMCID: PMC10033194 DOI: 10.1055/s-0042-1759760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
BACKGROUND Healthy brain aging can be defined as aging without neurological or psychiatric disorders, sustaining functional independence. In addition to the absence of disease and preserved functionality, there are individuals who stand out for their superior performance to that considered normal for their age in cognitive tests. These individuals are called "high-performance older adults" (HPOA). OBJECTIVES To investigate the presence of HPOA in an oldest-old population with low education, and if present, to investigate associations with sociodemographic, clinical, and lifestyle variables. METHODS We evaluated 132 cognitively healthy individuals from the Pietà Study, a population-based investigation with 639 participants. We used the delayed recall from the Rey Auditory-Verbal Learning Test to verify the existence of HPOA and to classify participants based on their performance. Sociodemographic, clinical, and lifestyle variables associated with HPOA were investigated. RESULTS We identified 18 individuals fulfilling HPOA criteria (age: 77.4 ± 2.6 years old; 14 women; education: 4.6 ± 3.4 years). The other participants, 114 total (age: 79.8 ± 4.5 years old; 69 women; education: 3.0 ± 2.7 years) were classified as "standard performance older adults" (SPOA). In multivariate analysis, younger age (odds ratio [OR] = 0.672; 95% confidence interval [CI]: 0.462-0.979; p = 0.037) and lower scores on the Geriatric Depression Scale (OR = 0.831; 95%CI: 0.688-0.989; p = 0.038) were associated with HPOA. CONCLUSIONS The present study identifies for the first time HPOA with low educational level, thereby reinforcing the existence of biological substrates related to this condition. Furthermore, the data suggest an association between younger age and less depressive symptoms with HPOA.
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Affiliation(s)
- Karoline Carvalho Carmona
- Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Faculdade de Medicina, Grupo de Pesquisa em Neurologia Comportamental e Cognitiva, Belo Horizonte MG, Brazil
- Faculdade de Ciências Médicas de Minas Gerais, Departamento de Clínica Médica, Belo Horizonte MG, Brazil
| | - Elisa de Paula França Resende
- Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Faculdade de Medicina, Grupo de Pesquisa em Neurologia Comportamental e Cognitiva, Belo Horizonte MG, Brazil
- Faculdade de Ciências Médicas de Minas Gerais, Departamento de Clínica Médica, Belo Horizonte MG, Brazil
| | - Henrique Cerqueira Guimarães
- Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Faculdade de Medicina, Grupo de Pesquisa em Neurologia Comportamental e Cognitiva, Belo Horizonte MG, Brazil
- Faculdade de Ciências Médicas de Minas Gerais, Departamento de Clínica Médica, Belo Horizonte MG, Brazil
| | - Thais Helena Machado
- Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Faculdade de Medicina, Grupo de Pesquisa em Neurologia Comportamental e Cognitiva, Belo Horizonte MG, Brazil
| | - Viviane Amaral-Carvalho
- Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Faculdade de Medicina, Grupo de Pesquisa em Neurologia Comportamental e Cognitiva, Belo Horizonte MG, Brazil
| | - Etelvina Lucas Dos Santos
- Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Faculdade de Medicina, Grupo de Pesquisa em Neurologia Comportamental e Cognitiva, Belo Horizonte MG, Brazil
| | - Maira Tonidandel Barbosa
- Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Faculdade de Medicina, Grupo de Pesquisa em Neurologia Comportamental e Cognitiva, Belo Horizonte MG, Brazil
- Faculdade de Ciências Médicas de Minas Gerais, Departamento de Clínica Médica, Belo Horizonte MG, Brazil
| | - Paulo Caramelli
- Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Faculdade de Medicina, Grupo de Pesquisa em Neurologia Comportamental e Cognitiva, Belo Horizonte MG, Brazil
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de Morais VAC, de Oliveira-Pinto AV, Mello Neto AF, Freitas JS, da Silva MM, Suemoto CK, Leite RP, Grinberg LT, Jacob-Filho W, Pasqualucci C, Nitrini R, Caramelli P, Lent R. Resilience of Neural Cellularity to the Influence of Low Educational Level. Brain Sci 2023; 13:brainsci13010104. [PMID: 36672086 PMCID: PMC9857353 DOI: 10.3390/brainsci13010104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/28/2022] [Accepted: 12/30/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Education is believed to contribute positively to brain structure and function, as well as to cognitive reserve. One of the brain regions most impacted by education is the medial temporal lobe (MTL), a region that houses the hippocampus, which has an important role in learning processes and in consolidation of memories, and is also known to undergo neurogenesis in adulthood. We aimed to investigate the influence of education on the absolute cell numbers of the MTL (comprised by the hippocampal formation, amygdala, and parahippocampal gyrus) of men without cognitive impairment. METHODS The Isotropic Fractionator technique was used to allow the anisotropic brain tissue to be transformed into an isotropic suspension of nuclei, and therefore assess the absolute cell composition of the MTL. We dissected twenty-six brains from men aged 47 to 64 years, with either low or high education. RESULTS A significant difference between groups was observed in brain mass, but not in MTL mass. No significant difference was found between groups in the number of total cells, number of neurons, and number of non-neuronal cells. Regression analysis showed that the total number of cells, number of neurons, and number of non-neuronal cells in MTL were not affected by education. CONCLUSIONS The results indicate a resilience of the absolute cellular composition of the MTL of typical men to low schooling, suggesting that the cellularity of brain regions is not affected by formal education.
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Affiliation(s)
- Viviane A. Carvalho de Morais
- Neuroplasticity Laboratory, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, RJ, Brazil
| | - Ana V. de Oliveira-Pinto
- Neuroplasticity Laboratory, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, RJ, Brazil
| | - Arthur F. Mello Neto
- Neuroplasticity Laboratory, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, RJ, Brazil
| | - Jaqueline S. Freitas
- Neuroplasticity Laboratory, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, RJ, Brazil
| | - Magnólia M. da Silva
- Biobank for Aging Studies, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-903, SP, Brazil
| | - Claudia Kimie Suemoto
- Biobank for Aging Studies, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-903, SP, Brazil
| | - Renata P. Leite
- Biobank for Aging Studies, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-903, SP, Brazil
| | - Lea T. Grinberg
- Memory and Aging Center, University of California San Francisco, San Francisco, CA 94158, USA
| | - Wilson Jacob-Filho
- Biobank for Aging Studies, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-903, SP, Brazil
- Laboratory of Medical Research in Aging (LIM-66), Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-903, SP, Brazil
| | - Carlos Pasqualucci
- Biobank for Aging Studies, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-903, SP, Brazil
| | - Ricardo Nitrini
- Biobank for Aging Studies, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-903, SP, Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research Group, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, MG, Brazil
| | - Roberto Lent
- Neuroplasticity Laboratory, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, RJ, Brazil
- D’Or Institute of Research and Education, Rio de Janeiro 22281-100, RJ, Brazil
- Correspondence:
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Amaral-Carvalho V, Bento Lima-Silva T, Inácio Mariano L, de Souza LC, Cerqueira Guimarães H, Santoro Bahia V, Nitrini R, Tonidandel Barbosa M, Sanches Yassuda M, Caramelli P. Predicting Dementia Due to Alzheimer's Disease and Behavioral Variant Frontotemporal Dementia Using Algorithms with the Addenbrooke's Cognitive Examination-Revised Subscores Combined with Sociodemographic Factors. Curr Alzheimer Res 2023; 20:341-349. [PMID: 37587822 DOI: 10.2174/1567205020666230816160700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/27/2023] [Accepted: 06/19/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD) are important causes of dementia with challenging differential diagnoses in many cases. Addenbrooke's Cognitive Examination-Revised (ACE-R) is a cognitive battery that may be useful to differentiate the two disorders. OBJECTIVE The objectibe of this study is to investigate the value of the ACE-R combined with sociodemographic factors in the differential diagnosis between AD and bvFTD. METHODS The ACE-R was administered to 102 patients with mild dementia due to probable AD, 37 with mild bvFTD, and 135 controls. Performances of patients and controls were analyzed by logistic regression and by ROC curves to refine the diagnostic accuracy of the ACE-R in AD and bvFTD. RESULTS The ACE-R subscores Attention and Orientation, Fluency, and Memory, in combination with schooling differentiated AD from controls with an area under the ROC curve (AUC) of 0.936 (86% sensitivity and 87% specificity). The ACE-R subscores Attention and Orientation, Fluency, and Language, in combination with sex (male), age, and schooling, discriminated bvFTD from controls with an AUC of 0.908 (81% sensitivity and 95% specificity). In the differentiation between AD and bvFTD, the ACE-R subscores Attention and Orientation, Fluency, and Language, together with age, displayed an AUC of 0.865 (78% sensitivity and 85% specificity). CONCLUSION The combination of ACE-R scores with sociodemographic data allowed good differentiation between AD and bvFTD in the study sample.
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Affiliation(s)
- Viviane Amaral-Carvalho
- Programa de Pós-Graduação em Neurologia, Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
- Behavior and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Thais Bento Lima-Silva
- Programa de Pós-Graduação em Neurologia, Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
- Escola de Artes, Ciências e Humanidades da Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Luciano Inácio Mariano
- Behavior and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Leonardo Cruz de Souza
- Behavior and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Henrique Cerqueira Guimarães
- Behavior and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Valeria Santoro Bahia
- Programa de Pós-Graduação em Neurologia, Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Ricardo Nitrini
- Programa de Pós-Graduação em Neurologia, Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Maira Tonidandel Barbosa
- Behavior and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mônica Sanches Yassuda
- Programa de Pós-Graduação em Neurologia, Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
- Escola de Artes, Ciências e Humanidades da Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Paulo Caramelli
- Programa de Pós-Graduação em Neurologia, Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
- Behavior and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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Affiliation(s)
| | - Hélio A G Teive
- Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Medicina Interna, Curitiba PR, Brazil
| | | | | | - Paulo Caramelli
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Belo Horizonte MG, Brazil
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Massaro A, Teive HAG, Caramelli P. Brazilian Academy of Neurology: 60 Years. Arq Neuropsiquiatr 2022; 80:1187-1188. [PMID: 36580954 PMCID: PMC9800162 DOI: 10.1055/s-0042-1760108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
| | - Hélio A. G. Teive
- Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Medicina Interna, Serviço de Neurologia, Curitiba PR, Brazil.,Address for correspondence Hélio A. Ghizoni Teive
| | - Paulo Caramelli
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte MG, Brazil.
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32
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Yassuda MS, Gil G, Apolinario D, Brucki SMD, Caramelli P, Nitrini R. Development of the Figure Memory Test and the Word Accentuation Test for the assessment of cognition in Brazil. Alzheimers Dement 2022. [DOI: 10.1002/alz.066970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Calandri IL, Crivelli L, Caramelli P, Lopera F, Nitrini R, Ortiz ALS, Suemoto CK, Salinas‐Contreras RM, Velilla LM, Yassuda MS, Sevlever G, Allegri RF, Initiative LFINGERS. LatAm Fingers Initiative: Challenges and opportunities of launching a multicultural trial in pandemic times. Alzheimers Dement 2022. [DOI: 10.1002/alz.061545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | | | | | - Francisco Lopera
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia Medellin Colombia
| | - Ricardo Nitrini
- Faculdade de Medicina da Universidade de São Paulo São Paulo Brazil
| | | | | | | | - Lina M Velilla
- Grupo de Neurociencias, Universidad de Antioquia Medellín Colombia
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Suemoto CK, Nitrini R, Grinberg LT, Leite REP, Pasquallucci CA, Bertola L, Vidal‐Ferreira N, Szlefj C, Caramelli P, Bensenor IM, Lotufo PA, Aliberti MJR, Ferri CP, Jacob‐Filho W. Risk and protective factors for dementia: epidemiological evidence and windows of opportunity. Alzheimers Dement 2022. [DOI: 10.1002/alz.062906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | | | - Lea Tenenholz Grinberg
- Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California San Francisco CA USA
| | | | | | | | | | | | | | | | - Paulo A Lotufo
- Center for Clinical and Epidemiological Research, Hospital Universitário, University of Sao Paulo, São Paulo, SP, Brazil Sao Paulo Brazil
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Sousa DC, Leite AS, Faria BCD, Sacramento LGG, Marinho CC, Caramelli P. Cognitive impairment one year after hospitalization due to COVID‐19 infection in Brazil: preliminary results. Alzheimers Dement 2022. [DOI: 10.1002/alz.065890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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36
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Calandri IL, Crivelli L, Caramelli P, Lopera F, Nitrini R, Ortiz ALS, Salinas‐Contreras RM, Suemoto CK, Velilla LM, Yassuda MS, Sevlever G, Allegri RF. LatAm FINGERS: Overcoming Barriers for a Dementia Prevention Trial Startup. Alzheimers Dement 2022. [DOI: 10.1002/alz.065869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | | | | | - Francisco Lopera
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia Medellin Colombia
| | | | | | | | | | - Lina M Velilla
- Grupo de Neurociencias, Universidad de Antioquia Medellín Colombia
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Resende EDPF, Lara VP, Santiago ALC, Friedlaender CV, Rosen HJ, Grinberg LT, Brown JA, Cobigo Y, Silva LLG, de Souza LC, Rincon LP, Maciel FI, Caramelli P. Literacy, but not memory, is associated with hippocampal connectivity in illiterate adults. Alzheimers Dement 2022. [DOI: 10.1002/alz.066620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Elisa de Paula França Resende
- Global Brain Health Institute, University of California San Francisco San Francisco CA USA
- Universidade Federal de Minas Gerais Belo Horizonte Brazil
| | | | | | | | - Howard J. Rosen
- Global Brain Health Institute, University of California San Francisco San Francisco CA USA
- University of California, San Francisco San Francisco CA USA
| | - Lea Tenenholz Grinberg
- Global Brain Health Institute, University of California San Francisco San Francisco CA USA
- University of California, San Francisco San Francisco CA USA
| | - Jesse A. Brown
- University of California, San Francisco San Francisco CA USA
| | - Yann Cobigo
- University of California, San Francisco San Francisco CA USA
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Suemoto CK, Mukadam N, Brucki SM, Caramelli P, Nitrini R, Laks J, Livingston G, Ferri CP. Risk factors for dementia in Brazil: Differences by region and race. Alzheimers Dement 2022; 19:1849-1857. [PMID: 36326095 DOI: 10.1002/alz.12820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 08/29/2022] [Accepted: 09/13/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Twelve risk factors (RFs) account for 40% of dementia cases worldwide. However, most data for population attributable fractions (PAFs) are from high-income countries (HIC). We estimated how much these RFs account for dementia cases in Brazil, stratifying estimates by race and socioeconomic level. METHODS We calculated the prevalence and communalities of 12 RFs using 9412 Brazilian Longitudinal Study of Aging participants, then stratified according to self-reported race and country macro-regions. RESULTS The overall weighted PAF was 48.2%. Less education had the largest PAF (7.7%), followed by hypertension (7.6%), and hearing loss (6.8%). PAF was 49.0% and 54.0% in the richest and poorest regions, respectively. PAFs were similar among White and Black individuals (47.8% and 47.2%, respectively) but the importance of the main RF varied by race. DISCUSSION Brazil's potential for dementia prevention is higher than in HIC. Education, hypertension, and hearing loss should be priority targets.
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Affiliation(s)
- Claudia K. Suemoto
- Division of Geriatrics Faculdade de Medicina Universidade de São Paulo São Paulo Brazil
| | | | - Sonia M.D. Brucki
- Department of Neurology Faculdade de Medicina Universidade de São Paulo São Paulo Brazil
| | - Paulo Caramelli
- Department of Internal Medicine Faculdade de Medicina Universidade Federal de Minas Gerais Belo Horizonte Brazil
| | - Ricardo Nitrini
- Department of Neurology Faculdade de Medicina Universidade de São Paulo São Paulo Brazil
| | - Jerson Laks
- Department of Psychiatry Universidade Federal do Rio de Janeiro Rio de Janeiro Brazil
| | | | - Cleusa P. Ferri
- Health Technology Assessment Unit Hospital Alemão Oswaldo Cruz São Paulo Brazil
- Department of Psychiatry Escola Paulista de Medicina Universidade Federal de São Paulo São Paulo Brazil
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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: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Quesque F, Coutrot A, Cox S, de Souza LC, Baez S, Cardona JF, Mulet-Perreault H, Flanagan E, Neely-Prado A, Clarens MF, Cassimiro L, Musa G, Kemp J, Botzung A, Philippi N, Cosseddu M, Trujillo-Llano C, Grisales-Cardenas JS, Fittipaldi S, Magrath Guimet N, Calandri IL, Crivelli L, Sedeno L, Garcia AM, Moreno F, Indakoetxea B, Benussi A, Brandão Moura MV, Santamaria-Garcia H, Matallana D, Pryanishnikova G, Morozova A, Iakovleva O, Veryugina N, Levin O, Zhao L, Liang J, Duning T, Lebouvier T, Pasquier F, Huepe D, Barandiaran M, Johnen A, Lyashenko E, Allegri RF, Borroni B, Blanc F, Wang F, Yassuda MS, Lillo P, Teixeira AL, Caramelli P, Hudon C, Slachevsky A, Ibáñez A, Hornberger M, Bertoux M. Does culture shape our understanding of others' thoughts and emotions? An investigation across 12 countries. Neuropsychology 2022; 36:664-682. [PMID: 35834208 DOI: 10.1037/neu0000817] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Measures of social cognition have now become central in neuropsychology, being essential for early and differential diagnoses, follow-up, and rehabilitation in a wide range of conditions. With the scientific world becoming increasingly interconnected, international neuropsychological and medical collaborations are burgeoning to tackle the global challenges that are mental health conditions. These initiatives commonly merge data across a diversity of populations and countries, while ignoring their specificity. OBJECTIVE In this context, we aimed to estimate the influence of participants' nationality on social cognition evaluation. This issue is of particular importance as most cognitive tasks are developed in highly specific contexts, not representative of that encountered by the world's population. METHOD Through a large international study across 18 sites, neuropsychologists assessed core aspects of social cognition in 587 participants from 12 countries using traditional and widely used tasks. RESULTS Age, gender, and education were found to impact measures of mentalizing and emotion recognition. After controlling for these factors, differences between countries accounted for more than 20% of the variance on both measures. Importantly, it was possible to isolate participants' nationality from potential translation issues, which classically constitute a major limitation. CONCLUSIONS Overall, these findings highlight the need for important methodological shifts to better represent social cognition in both fundamental research and clinical practice, especially within emerging international networks and consortia. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
| | | | - Sharon Cox
- Department of Behavioural Science and Health
| | | | | | | | | | | | | | | | | | | | | | - Anne Botzung
- Centre Memoire de Ressources et Recherche (CMRR)
| | | | | | | | | | | | | | | | | | - Lucas Sedeno
- National Scientific and Technical Research Council (CONICET)
| | | | | | | | | | | | | | | | | | - Anna Morozova
- Central Clinic No 1 of the Ministry of Internal Affairs
| | - Olga Iakovleva
- Russian Medical Academy of Continuous Professional Education
| | | | - Oleg Levin
- Russian Medical Academy of Continuous Professional Education
| | - Lina Zhao
- Innovation Center for Neurological Disorders
| | | | | | | | | | - David Huepe
- Center for Social and Cognitive Neuroscience
| | | | | | - Elena Lyashenko
- Russian Medical Academy of Continuous Professional Education
| | | | | | | | - Fen Wang
- Innovation Center for Neurological Disorders
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41
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Souza LCD, Hosogi ML, Machado TH, Carthery-Goulart MT, Yassuda MS, Smid J, Barbosa BJAP, Schilling LP, Balthazar MLF, Frota NAF, Vale FAC, Caramelli P, Bertolucci PHF, Chaves MLF, Brucki SMD, Nitrini R, Bahia VS, Takada LT. Diagnóstico da demência frontotemporal: recomendações do Departamento Científico de Neurologia Cognitiva e do Envelhecimento da Academia Brasileira de Neurologia. Dement Neuropsychol 2022; 16:40-52. [DOI: 10.1590/1980-5764-dn-2022-s103pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 12/08/2021] [Accepted: 04/27/2022] [Indexed: 11/30/2022] Open
Abstract
RESUMO A “demência frontotemporal” (DFT) é uma síndrome clínica, cujo denominador comum é o acometimento focal dos lobos frontais e/ou temporais. A DFT tem três fenótipos clínicos distintos: a variante comportamental e dois subtipos linguísticos, a saber, a afasia progressiva primária não-fluente/agramática (APP-NF/A) e a afasia progressiva primária semântica (APP-S). A DFT é a segunda causa mais comum de demência em indivíduos com idade inferior a 65 anos, após a doença de Alzheimer. O presente artigo apresenta recomendações para diagnóstico da DFT no cenário brasileiro, considerando os três níveis de complexidade do sistema de saúde: atenção primária à saúde e níveis secundários. São propostos protocolos de investigação diagnóstica abrangendo testagem cognitiva, avaliação comportamental, avaliação fonoaudiológica, exames laboratoriais e de neuroimagem.
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Affiliation(s)
- Leonardo Cruz de Souza
- Universidade Federal de Minas Gerais, Brasil; Universidade Federal de Minas Gerais, Brasil
| | | | - Thais Helena Machado
- Universidade Federal de Minas Gerais, Brasil; Universidade Federal de Minas Gerais, Brasil
| | | | | | | | - Breno José Alencar Pires Barbosa
- Universidade de São Paulo, Brasil; 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
| | | | | | | | - Paulo Caramelli
- Universidade Federal de Minas Gerais, Brasil; Universidade Federal de Minas Gerais, Brasil
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42
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Parmera JB, Tumas V, Ferraz HB, Spitz M, Barbosa MT, Smid J, Barbosa BJAP, Schilling LP, Balthazar MLF, Souza LCD, Vale FAC, Caramelli P, Bertolucci PHF, Chaves MLF, Brucki SMD, Nitrini R, Castilhos RM, Frota NAF. Diagnóstico e manejo da demência da doença de Parkinson e demência com corpos de Lewy: recomendações do Departamento Científico de Neurologia Cognitiva e do Envelhecimento da Academia Brasileira de Neurologia. Dement Neuropsychol 2022; 16:73-87. [DOI: 10.1590/1980-5764-dn-2022-s105pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/13/2021] [Accepted: 04/27/2022] [Indexed: 11/29/2022] Open
Abstract
RESUMO A demência da doença de Parkinson (DDP) e a demência com corpos de Lewy (DCL) representam a segunda causa mais comum de demência neurodegenerativa em pessoas com mais de 65 anos, ocasionando progressivo declínio cognitivo e comprometimento da qualidade de vida. O presente estudo tem como objetivo prover um consenso de especialistas sobre a DDP e DCL, baseado em revisão sistemática da literatura brasileira e revisão não-sistemática de literatura internacional. Ademais, tal estudo visa promover informação e conceder recomendações sobre abordagem diagnóstica, com foco nos níveis de atenção primária e secundária em saúde. Com base nos dados disponíveis, recomendamos que os profissionais realizem pelo menos um breve instrumento cognitivo global, como o Mini-Exame do Estado Mental, contudo de preferência optem pela Avaliação Cognitiva de Montreal e o Exame Cognitivo de Addenbrooke-Revisado. Observa-se uma carência de instrumentos validados para a avaliação precisa das habilidades funcionais em pacientes brasileiros com DDP e DCL. Além disso, mais estudos focando em biomarcadores com coortes brasileiras também são necessários.
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Affiliation(s)
| | | | | | | | - Maira Tonidandel Barbosa
- Universidade Federal de Minas Gerais, Brasil; Faculdade Ciências Médicas de Minas Gerais, Brasil
| | | | - Breno José Alencar Pires Barbosa
- Universidade de São Paulo, Brasil; 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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43
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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44
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Smid J, Studart-Neto A, César-Freitas KG, Dourado MCN, Kochhann R, Barbosa BJAP, Schilling LP, Balthazar MLF, Frota NAF, Souza LCD, Caramelli P, Bertolucci PHF, Chaves MLF, Brucki SMD, Nitrini R, Resende EDPF, Vale FAC. Subjective cognitive decline, mild cognitive impairment, and dementia - syndromic approach: 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-s101en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
ABSTRACT This consensus, performed by the Brazilian Academy of Neurology (BAN) will approach practically how to evaluate patients with cognitive complaints and how to clinically and etiologically diagnose the three clinical syndromes associated with the different stages of cognitive decline: subjective cognitive decline (SCD), mild cognitive impairment (MCI), and dementia. This BAN consensus discusses SCD diagnosis for the first time, updates MCI and dementia diagnoses, recommends the adequate cognitive tests and the relevant etiological work-up and care of patients with cognitive decline at different levels of care within the Brazilian Unified Health System. We also review the main assessment instruments used in Brazil and Latin America.
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Affiliation(s)
| | | | | | | | | | - Breno José Alencar Pires Barbosa
- Universidade de São Paulo, Brasil; 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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45
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Smid J, Studart-Neto A, César-Freitas KG, Dourado MCN, Kochhann R, Barbosa BJAP, Schilling LP, Balthazar MLF, Frota NAF, Souza LCD, Caramelli P, Bertolucci PHF, Chaves MLF, Brucki SMD, Nitrini R, Resende EDPF, Vale FAC. Declínio cognitivo subjetivo, comprometimento cognitivo leve e demência - diagnóstico sindrômico: recomendações do Departamento Científico de Neurologia Cognitiva e do Envelhecimento da Academia Brasileira de Neurologia. Dement Neuropsychol 2022; 16:1-24. [DOI: 10.1590/1980-5764-dn-2022-s101pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 01/03/2022] [Accepted: 04/27/2022] [Indexed: 12/15/2022] Open
Abstract
RESUMO Este consenso realizado pela Academia Brasileira de Neurologia (ABN) abordará de maneira prática como avaliar pacientes com queixas cognitivas e como realizar o diagnóstico clínico e etiológico das três síndromes clínicas associadas aos estágios de declínio cognitivo: declínio cognitivo subjetivo (DCS), comprometimento cognitivo leve (CCL) e demência. O diagnóstico de DCS é discutido pela primeira vez em consenso da ABN e as atualizações para o diagnóstico de CCL e demência são abordadas, bem como a recomendação para o uso de testes cognitivos apropriados, investigação etiológica pertinente e cuidados aos pacientes com declínio cognitivo nos diferentes níveis de atenção do Sistema Único de Saúde. Foi realizada pesquisa dos principais instrumentos de avaliação utilizados em nosso meio e na América Latina.
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Affiliation(s)
| | | | | | | | | | - Breno José Alencar Pires Barbosa
- Universidade de São Paulo, Brasil; 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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46
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Barbosa BJAP, Siqueira Neto JI, Alves GS, Sudo FK, Suemoto CK, Tovar-Moll F, Smid J, Schilling LP, Balthazar MLF, Frota NAF, Souza LCD, Vale FAC, Caramelli P, Bertolucci PHF, Brucki SMD, Nitrini R, Engelhardt E, Chaves MLF. Diagnosis of vascular cognitive impairment: 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-s104en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
ABSTRACT Since the publication of the latest recommendations for the diagnosis and treatment of Vascular Dementia by the Brazilian Academy of Neurology in 2011, significant advances on the terminology and diagnostic criteria have been made. This manuscript is the result of a consensus among experts appointed by the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology (2020-2022). We aimed to update practical recommendations for the identification, classification, and diagnosis of Vascular Cognitive Impairment (VCI). Searches were performed in the MEDLINE, Scopus, Scielo, and LILACS databases. This guideline provides a comprehensive review and then synthesizes the main practical guidelines for the diagnosis of VCI not only for neurologists but also for other professionals involved in the assessment and care of patients with VCI, considering the different levels of health care (primary, secondary and tertiary) in Brazil.
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Affiliation(s)
- Breno José Alencar Pires Barbosa
- Universidade Federal de Pernambuco, Brasil; Instituto de Medicina Integral Prof. Fernando Figueira, Brasil; Universidade de São Paulo, 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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47
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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48
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Souza LCD, Hosogi ML, Machado TH, Carthery-Goulart MT, Yassuda MS, Smid J, Barbosa BJAP, Schilling LP, Balthazar MLF, Frota NAF, Vale FAC, Caramelli P, Bertolucci PHF, Chaves MLF, Brucki SMD, Nitrini R, Bahia VS, Takada LT. Diagnosis of frontotemporal 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-s103en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
ABSTRACT “Frontotemporal dementia” (FTD) is a clinical syndrome characterized by the focal involvement of the frontal and/or temporal lobes. FTD has three clinical phenotypes: the behavioral variant and two linguistic subtypes, namely, non-fluent/agrammatic primary progressive aphasia (PPA-NF/A) and semantic PPA (PPA-S). FTD is the second most common cause of dementia in individuals under the age of 65 years. This article presents recommendations for the diagnosis of FTD in the Brazilian scenario, considering the three levels of complexity of the health system: primary health care, secondary and tertiary levels. Diagnostic guidelines are proposed, including cognitive testing, behavioral and language assessments, laboratory tests, and neuroimaging.
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Affiliation(s)
- Leonardo Cruz de Souza
- Universidade Federal de Minas Gerais, Brasil; Universidade Federal de Minas Gerais, Brasil
| | | | - Thais Helena Machado
- Universidade Federal de Minas Gerais, Brasil; Universidade Federal de Minas Gerais, Brasil
| | | | | | | | - Breno José Alencar Pires Barbosa
- Universidade de São Paulo, Brasil; 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
| | | | | | | | - Paulo Caramelli
- Universidade Federal de Minas Gerais, Brasil; Universidade Federal de Minas Gerais, Brasil
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49
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Schilling LP, Balthazar MLF, Radanovic M, Forlenza OV, Silagi ML, Smid J, Barbosa BJAP, Frota NAF, Souza LCD, Vale FAC, Caramelli P, Bertolucci PHF, Chaves MLF, Brucki SMD, Damasceno BP, Nitrini R. Diagnosis of Alzheimer’s disease: 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-s102en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
ABSTRACT This paper presents the consensus of the Scientific Department of Cognitive Neurology and Aging from the Brazilian Academy of Neurology on the diagnostic criteria for Alzheimer’s disease (AD) in Brazil. The authors conducted a literature review regarding clinical and research criteria for AD diagnosis and proposed protocols for use at primary, secondary, and tertiary care levels. Within this clinical scenario, the diagnostic criteria for typical and atypical AD are presented as well as clinical, cognitive, and functional assessment tools and complementary propaedeutics with laboratory and neuroimaging tests. The use of biomarkers is also discussed for both clinical diagnosis (in specific conditions) and research.
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Affiliation(s)
- 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
| | | | | | | | - Marcela Lima Silagi
- Universidade Federal de São Paulo, Brasil; Universidade de São Paulo, Brasil
| | | | - Breno José Alencar Pires Barbosa
- Universidade de São Paulo, Brasil; Universidade Federal de Pernambuco, Brasil; Instituto de Medicina Integral Prof. Fernando Figueira, Brasil
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50
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Parmera JB, Tumas V, Ferraz HB, Spitz M, Barbosa MT, Smid J, Barbosa BJAP, Schilling LP, Balthazar MLF, Souza LCD, Vale FAC, Caramelli P, Bertolucci PHF, Chaves MLF, Brucki SMD, Nitrini R, Castilhos RM, Frota NAF. Diagnosis and management of Parkinson’s disease dementia and dementia with Lewy bodies: 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-s105en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
ABSTRACT Parkinson’s disease dementia (PDD) and dementia with Lewy bodies (DLB) represent the second most common type of degenerative dementia in patients aged 65 years and older, leading to progressive cognitive dysfunction and impaired quality of life. This study aims to provide a consensus based on a systematic Brazilian literature review and a comprehensive international review concerning PDD and DLB. Moreover, we sought to report on and give recommendations about the best diagnostic approaches focusing on primary and secondary care. Based on the available data, we recommend clinicians to apply at least one brief global cognitive instrument to assess PDD, such as the Mini-Mental State Examination and preferably the Montreal Cognitive Assessment and the Addenbrooke’s Cognitive Examination-Revised. Validated instruments to accurately assess functional abilities in Brazilian PD patients are still incipient. Further studies should focus on biomarkers with Brazilian cohorts.
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Affiliation(s)
| | | | | | | | - Maira Tonidandel Barbosa
- Universidade Federal de Minas Gerais, Brasil; Faculdade Ciências Médicas de Minas Gerais, Brasil
| | | | - Breno José Alencar Pires Barbosa
- Universidade de São Paulo, Brasil; 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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