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"Soto-Añari, Marcio"
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Factors associated with cognitive impairment in Latin American older adults: A cross‐sectional observational study of COVID‐19 confinement
by
Aguilar, Dolores
,
Varón, Claudia
,
Antezana, Regulo
in
Aging
,
Alzheimer's disease
,
Cognitive ability
2023
INTRODUCTION The effects of COVID‐19 confinement have been severe, especially in older adults. Therefore, we analyzed the factors associated with cognitive impairment (CI) in Latin America (LA). METHODS We conducted a cross‐sectional observational study with a total of 5245 older adults from 10 countries in LA. Measurement We used the Telephone Montreal Cognitive Assessment (T‐MoCA) and the Eight‐item Informant Interview to Differentiate Aging and Dementia (AD8) scale. RESULTS We found that age, depressive symptomatology, bone fractures, being widowed, having a family member with dementia, and unemployment were associated with an increased risk of CI. In contrast, higher education, hypertension with continuous treatment, quarantine, and keeping stimulating cognitive and physical activities were associated with a lower probability of CI. No significant association was found between suffering from diabetes or being retired and CI. DISCUSSION It is essential to conduct follow‐up studies on these factors, considering their relationship with CI and the duration of confinement.
Journal Article
Clinical Manifestations
by
Tosto, Giuseppe
,
Custodio, Belen
,
Ore-Gomez, Maria Fernanda
in
Aged
,
Aged, 80 and over
,
Caribbean Region
2024
The global aging population raises concerns about increased neurodegenerative diseases, particularly in low- and middle-income countries like Latin America and the Caribbean. However, the situation among the indigenous inhabitants remains unknown due to various barriers, including cultural diversity, lack of studies, low awareness, language barriers, and limited healthcare access. Brief cognitive tests like the Rowland Universal Dementia Assessment Scale (RUDAS) show promise in overcoming these challenges.
A secondary analysis was conducted on a substantial patient cohort derived from the GAPP study (NIA grant #alz093273AG069118), categorizing participants based on whether their native language was Spanish or Quechua/Aymara. Descriptive analysis of variables was performed, with the Wilcoxon test applied to compare total RUDAS scores among distinct patient groups, including controls, individuals with Mild Cognitive Impairment (MCI), and those with dementia. Comparisons were specifically made between Spanish speakers and native language speakers. Additionally, the ROC (Receiver Operating Characteristic) curve was employed to evaluate the discriminative capacity of RUDAS in distinguishing between controls and dementia, as well as between controls/MCI and dementia cases within native and Spanish-speaking populations.
A total of 405 controls, 126 individuals with Mild Cognitive Impairment (MCI), and 133 participants with dementia were included in the analysis. Among them, 91 patients were native language speakers, with a median age of 74 (range 54 - 92). The majority were female (69.2%), and 65.9% were Aymara speakers. Native participants reported an average education level of 3.1 years (SD 4.4). The RUDAS mean score was lower in the native speaker group compared to Spanish-speaking participants (21 vs. 23). Additionally, the analysis revealed significantly lower scores in controls within the native speaker group (Fig. 1). Diagnostic performance for native speakers was poor when comparing control/MCI (Fig. 2) vs. dementia and control vs. dementia (Fig. 3).
The use of the RUDAS in native language speakers and its ability to distinguish between Mild Cognitive Impairment (MCI) and dementia raise some concerns. To improve assessments for various communities in Latin America and the Caribbean, there is a need for culturally adapted brief cognitive tests.
Journal Article
El Design Organization Test (DOT) en adultos peruanos: parámetros de validación y normativos
by
Soto-Añari, Marcio Marcio
,
César Merino Soto
,
Danitsa Alarcón Parco
in
Assessment
,
avaliação
,
BEHAVIORAL SCIENCES
2020
El presente estudio reporta la información normativa y psicométrica del DOT (forma A y B), una medida breve de organización perceptual-visual relevante para la investigación aplicada y la práctica clínica. Participó una muestra efectiva de 775 adultos universitarios, de Lima (Perú). La administración del test se hizo en grupo, con instrucciones estandarizadas. Se halló que la confiabilidad test-retest era moderadamente alta; la covariación con una prueba de inteligencia fluida fue pequeña, pero teóricamente consistente. La información clínico-métrica sobre el error de medición y el cambio confiable fue adecuada (mínimo cambio detectable). Las diferencias intra-grupos y entre-grupos (muestra americana) revelaron patrones de resultados esencialmente consistentes, detectándose un efecto de la práctica comparativamente mayor en la muestra peruana. Se discuten las implicaciones de los resultados.
Journal Article
Plasma phospho-tau217 as a predictive biomarker for Alzheimer’s disease in a large south American cohort
by
Tosto, Giuseppe
,
Cieza, Basilio
,
Reyes-Dumeyer, Dolly
in
Aged
,
Aged, 80 and over
,
Alzheimer Disease - blood
2025
Background
Blood-based Alzheimer’s disease (AD) biomarkers have been increasingly employed for diagnostic, prognostic, and therapeutic monitoring purposes, due to accuracy in distinguishing AD pathophysiologic process. Compared to other p-tau isoforms, plasma p-tau217 exhibits stronger associations with AD hallmarks in CSF and brain. However, most studies have been conducted in non-Hispanic Whites, limiting our understanding of the performances and utility of these biomarkers across ethnicities.
Methods
We examined a cohort of Peruvians from the GAPP study, a recently established cohort of Peruvian mestizos from Lima and indigenous groups from Southern Peru (Aymaras and Quechuas). We tested plasma levels of p-tau using the Quanterix Simoa ALZpathp-tau217 assay in 525 samples and tested the association between p-tau217 and clinical diagnosis (healthy controls
n
= 234 vs. AD
n
= 113) using generalized mixed regression models, adjusting for sex, age, education,
APOE
-e4 allele (fixed effects) and study site (random effect). We also tested biomarker levels in MCI (
n
= 178) vs. other groups. The receiver operating characteristics area under the curve (ROC-AUC) was used to evaluate the biomarker’s classification performances.
Result
Participants showed on average 80% Native American ancestry. p-tau217 was significantly associated with AD (β = 2.61, 95%CI = 0.61–4.29) and its levels were inversely correlated with cognitive performances; p-tau217 levels did not differ between controls and MCI (p-value > 0.05). p-tau217 levels were higher in participants carrying at least one
APOE
-e4 allele (OR = 2.31, 95%CI = 1.85–2.90). The ROC-AUC for p-tau217 was estimated at 82.82% in the fully adjusted model.
Conclusion
To our knowledge, this is the largest study conducted in a South American cohort phenotyped for AD with available p-tau217. Most investigations have previously focused on highly selected cohorts with established AD-endophenotypes (CSF biomarkers, autopsy report, PET etc.), while data on cohorts with clinical assessment are currently lacking, especially in non-European populations.
Journal Article
Impact of quarantine due to COVID-19 pandemic on health and lifestyle conditions in older adults from Centro American countries
by
Cárdenas-Valverde, Juan-Carlos
,
Mendoza-Ruvalcaba, Neyda Ma
,
Ramos-Henderson, Miguel
in
Activities of Daily Living
,
Adults
,
Aged
2022
The impact of quarantine in older adults have been reported in several studies with contradictory results, reporting from negative effects to no significant outcomes or even beneficial consequences. Heterogeneity in aging plays a role in each region, the aim of this study is to analyze the impact of quarantine on health conditions (physical and mental) and lifestyle in older adults in five Centro American countries during COVID-19 pandemic.
In this cross-sectional study, n = 712 older adults 60 years and older from Mexico, Guatemala, El Salvador, Honduras and Costa Rica were assessed by telephone. Sociodemographic data, physical and mental health, lifestyle and quarantine conditions were asked previous informed consent.
In general, mean of days in quarantine at the moment of the study was 142 days (approximately four months and three weeks). In the analysis of the impact of the days in quarantine effects were found on the frequency of falls, functional ability in Activities of Daily Living (ADL), general cognitive function, memory, orientation, language, frequency of drinking alcohol, having a balanced diet, and being active cognitively. Some differences were found between countries.
Effects of quarantine on older adults in Centro America, requires attention of governments and healthcare to prevent long term morbidity and disability, and to promote healthy aging.
Journal Article
APOE and Alzheimer's disease and related dementias risk among 12,221 Hispanics/Latinos
2025
BACKGROUND Effect of apolipoprotein E (APOE) on Alzheimer's disease and related dementias (ADRD) risk is heterogeneous across populations, with scarce data on Hispanics/Latinos. METHODS APOE genotype was studied in 12,221 Hispanics/Latinos (per cohort and via metanalysis): Caribbean‐Hispanics, Mexicans, Mexican‐Americans, and Peruvians/Bolivians. A subsample had longitudinal assessment and plasma p‐tau. We tested the modifying effects of global and local ancestries. Results were replicated in an independent Peruvian cohort and brain samples. RESULTS APOE ε4 effect was strongest in Peruvians/Bolivians (odds ratio [OR] = 6.13, 95% confidence interval [CI] = 2.71–13.83), followed by Mexicans (OR = 4.31, 95% CI = 1.58–11.74), Mexican‐Americans (OR = 3.06, 95% CI = 2.04–4.59), and Caribbean‐Hispanics (OR = 2.22, 95% CI = 1.99–2.48). Meta‐analyses showed OR = 2.32 (95% CI = 2.09–2.57) and OR = 0.81 (95% CI = 0.68–0.97) for the ε4 and ε2 allele, respectively. The APOE ε4 effect was replicated independently in Peruvians (OR = 5.06, 95% CI = 2.48–10.70). ε4 carriers displayed higher ADRD conversions and p‐tau levels. Global and local ancestries did not modify ADRD risk, and they were associated with Braak stage. DISCUSSION APOE shows a heterogeneous effect on ADRD risk in our Hispanics/Latinos sample, the largest to date. Highlights The apolipoprotein E (APOE) ε4 effect is stronger in Peruvians/Bolivians than in other Hispanic/Latino groups. The strong APOE effect size in Peruvians and Bolivians was replicated in a second independent Peruvian cohort. Meta‐analysis for ε4 and ε2 confirmed a significant association with Alzheimer's disease and related dementias (ADRD). Global and local ancestry do not modify the association between APOE genotype and ADRD.
Journal Article
Driving research on successful aging and neuroprotection in Latin America: Insights from the inaugural symposium on brain resilience and healthy longevity
by
Slachevsky, Andrea
,
Cardona‐Gómez, Gloria Patricia
,
Vasquez, Daniel
in
Aged, 80 and over
,
Aging
,
Alzheimer Disease - genetics
2025
INTRODUCTION Global life expectancy has steadily increased in recent decades, resulting in a significant rise in the number of individuals aged 80 years and older. This trend is also evident in Latin America, where life expectancy is improving, though at varying rates across countries and regions. METHODS Partnering with the Neurosciences Group of Antioquia (GNA), we launched a Colombian study on resilience in families with autosomal dominant Alzheimer's disease and the oldest‐old population. Over the past 2 years, the project has expanded to include participants from Peru, Chile, and Costa Rica. RESULTS This research led to the first symposium on Brain Resilience and Healthy Longevity, held in Medellín, Colombia, in August 2024. DISCUSSION The article summarizes key discussions from the symposium, highlighting the most promising opportunities for brain resilience and prevention research in the region and offering recommendations for future research to promote healthy aging and dementia‐free communities. Highlights Uncovering the genetic and physiological drivers of cognitive resilience, neurodegeneration resistance, and healthy longevity is essential for maintaining brain function as we age. “Superagers” and cognitively resilient individuals from Latin American families with Alzheimer's disease offer valuable insights into brain protection mechanisms. Studying the interplay of socio‐environmental and genetic factors in the oldest‐old is key to understanding healthy longevity and improving dementia prevention. The inaugural Brain Resilience and Healthy Longevity Symposium highlights the need for global collaboration to uncover factors that drive cognitive resilience and healthy aging in Latin America, advancing dementia prevention.
Journal Article
Prevalence of Dementia and Associated Factors among Older Adults in Latin America during the COVID-19 Pandemic
by
Ramos-Henderson, Miguel
,
Caldichoury-Obando, Nicole
,
Mori, Nicanor
in
aging
,
Caregivers
,
Cognitive ability
2021
Abstract
Background: The COVID-19 pandemic has had a great impact on cognitive health in Latin American older adults, increasing the risk of cognitive impairment and dementia. Our objective was to analyze the prevalence of dementia and the associated factors in Latin American older adults during SARS-CoV-2 pandemic. Methods: A multicentric first phase cross-sectional observational study was conducted during the SARS-CoV-2 pandemic. Five thousand two hundred and forty-five Latin American adults over 60 years of age were studied in 10 countries: Argentina, Bolivia, Chile, Colombia, Ecuador, Guatemala, Mexico, Peru, the Dominican Republic, and Venezuela. We used the telephone version of Montreal Cognitive Assessment, the “Alzheimer Disease 8” scale for functional and cognitive changes, and the abbreviated version of the Yesavage depression scale. We also asked for sociodemographic and lockdown data. All the evaluation was made by telephone. Cross-tabulations and χ2 tests were used to determine the variability of the prevalence of impairment by sociodemographic characteristics and binary logistic regression to assess the association between dementia and sociodemographic factors. Results: We observed that the prevalence of dementia in Latin America is 15.6%, varying depending on the country (Argentine = 7.83 and Bolivia = 28.5%). The variables most associated with dementia were race and age. It does not seem to be associated with the pandemic but with social and socio-health factors. Conclusion: The prevalence of dementia shows a significant increase in Latin America, attributable to a constellation of ethnic, demographic, and socioeconomic factors.
Journal Article
Diferencias en tareas de función ejecutiva entre adolescentes y adultos mayores bilingües y monolingües
by
Cáceres-Luna, Gabriela
,
Araoz Coacalla, María
,
Belón-Hercilla, Verónica
in
adolescentes
,
adultos mayores
,
Bilingualism
2021
Nos propusimos comparar el rendimiento en tareas de función ejecutiva entre adolescentes y adultos mayores bilingües y monolingües. Utilizamos un diseño comparativo transversal. Evaluamos a 48 personas monolingües (24 adolescentes y 24 adultos mayores) y 56 bilingües (31 adolescentes y 25 adultos mayores) con una amplia batería neuropsicológica que comprendían tareas de flexibilidad cognitiva (Wisconsin Card Sorting Test), control inhibitorio (test de Stroop), memoria de trabajo (subescalas de Retención de dígitos, Secuencia de números y letras: test Wechsler de inteligencia) y acceso a la memoria a largo plazo (fluidez semántica y fonológica). Nuestros resultados indican que los adolescentes y adultos mayores monolingües rinden mejor en las pruebas de control ejecutivo que sus pares bilingües, siendo estas diferencias menores en los adultos mayores y no parecen asociarse a la edad y a la frecuencia de uso de L1 (castellano) y L2 (quechua). Estos resultados muestran que durante la adolescencia hay una desventaja a nivel ejecutivo en las personas bilingües, la cual parece disminuir en la adultez. Se discuten los resultados a la luz del peso de los factores socioculturales y a la posibilidad de entender al bilingüismo como un mecanismo ligado a la reserva cognitiva. Our purpose was to compare performance in executive function tasks between bilingual and monolingual adolescents and older adults. A cross-sectional design was used. We evaluated 48 monolinguals (24 adolescents and 24 older adults) and 56 bilinguals (31 adolescents and 25 older adults) with a wide neuropsychological battery that included tasks of cognitive flexibility (Wisconsin card sorting test), inhibitory control (Stroop test), working memory (direct and inverse digits) and access to long-term memory (semantic and phonological fluency). Our results indicate that monolingual adolescents and older adults perform better in executive control tests than their bilingual counterparts, and these differences are minor in bilingual older adults, these differences do not seem to be associated with age and the frequency of use of L1 (Spanish) and L2 (Quechua). These results seem to show that during adolescence there is a cognitive disadvantage in executive function, which is reduced when people get older. The results are discussed considering sociocultural factors and the possibility of understanding bilingualism as a mechanism linked to cognitive reserve.
Journal Article