Browsing by Author "Custodio, Nilton"
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Publication Biomarkers for dementia in Latin American countries: Gaps andopportunities(2023) Parra, Mario A.; Orellana, Paulina; León, Tomas; Victoria, Cabello G.; Henriquez, Fernando; Gomez, Rodrigo; Avalos, Constanza; Damian, Andres; Slachevsky Chonchol, Andrea; Ibañez, Agustin; Zetterberg, Henrik; Tijms, Betty M.; Yokoyama, Jennifer S.; Piña-Escudero, Stefanie D.; Cochran, Nicholas; Matallana, Diana L.; Acosta, Daisy; Allegri, Ricardo; Arias-Suáres, Bianca P.; Barra, Bernardo; Behrens, María Isabel; Brucki, Sonia M.D.; Busatto, Geraldo; Caramelli, Paulo; Castro-Suarez, Sheila; Contreras, Valeria; Custodio, Nilton; Dansilio, Sergio; De la Cruz-Puebla, Myriam; Cruz de Souza, Leonado; Díaz, Monica M.; Duque, Lissette; Farias, Gonzalo A.; Ferreira, Sergio T.; Magrath Guimet, Nahuel; Kmaid, Ana; Lira, David; Lopera, Francisco; Mar Meza, Beatriz; Miotto, Eliane C.Limited knowledge on dementia biomarkers in Latin American and Caribbean (LAC)countries remains a serious barrier. Here, we reported a survey to explore the ongo-ing work, needs, interests, potential barriers, and opportunities for future studiesrelated to biomarkers. The results show that neuroimaging is the most used biomarker(73%), followed by genetic studies (40%), peripheral fluids biomarkers (31%), and cere-brospinal fluid biomarkers (29%). Regarding barriers in LAC, lack of funding appears toundermine the implementation of biomarkers in clinical or research settings, followedby insufficient infrastructure and training. The survey revealed that despite the abovebarriers, 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 allowedus to propose an action plan that addresses the recommendations for a biomarkerframework recently proposed by regional experts.Publication Classification of Alzheimer’s disease and frontotemporal dementia using routine clinical and cognitive measures across multicentric underrepresented samples: a cross sectional observational study(2023) Maito, Marcelo Adrián; Santamaría-García, Hernando; Moguilner, Sebastián; Possin, Katherine L.; Godoy, María E.; Avila-Funes, José Alberto; Behrens, Maria Isabel; Brusco, Ignacio L. Maira Okada de Oliveira,b,r,s,ae Stefanie D. Pina-Escuder; Bruno, Martín A.; Cardona, Juan F.; Custodio, Nilton; García, Adolfo M.; Javandel, Shireen; Lopera, Francisco; Matallana, Diana L.; Miller, Bruce; Okada de Oliveira, Maira; Pina Escudero, Stefanie; Slachevsky Chonchol, Andrea; Ana L Sosa Ortiz; Takada, Leonel T.; Tagliazuchi, Enzo; Valcour, Victor; Yokoyama, Jennifer S.; Ibañez, AgustínBackground Global brain health initiatives call for improving methods for the diagnosis of Alzheimer’s disease (AD) and frontotemporal dementia (FTD) in underrepresented populations. However, diagnostic procedures in upper middle-income countries (UMICs) and lower-middle income countries (LMICs), such as Latin American countries (LAC), face multiple challenges. These include the heterogeneity in diagnostic methods, lack of clinical harmonisation, and limited access to biomarkers. Methods This cross-sectional observational study aimed to identify the best combination of predictors to discriminate between AD and FTD using demographic, clinical and cognitive data among 1794 participants [904 diagnosed with AD, 282 diagnosed with FTD, and 606 healthy controls (HCs)] collected in 11 clinical centres across five LAC (ReDLat cohort). Findings A fully automated computational approach included classical statistical methods, support vector machine procedures, and machine learning techniques (random forest and sequential feature selection procedures). Results demonstrated an accurate classification of patients with AD and FTD and HCs. A machine learning model produced the best values to differentiate AD from FTD patients with an accuracy = 0.91. The top features included social cognition, neuropsychiatric symptoms, executive functioning performance, and cognitive screening; with secondary contributions from age, educational attainment, and sex. Interpretation Results demonstrate that data-driven techniques applied in archival clinical datasets could enhance diagnostic procedures in regions with limited resources. These results also suggest specific fine-grained cognitive and behavioural measures may aid in the diagnosis of AD and FTD in LAC. Moreover, our results highlight an opportunity for harmonisation of clinical tools for dementia diagnosis in the region.Item Dementia in Latin America: Epidemiological Evidence and Implications for Public Policy(Frontiers Research Foundation, 2017) Custodio, Nilton; Wheelock, Ana; Thumala, Daniela; Slachevsky, AndreaPopulation aging is among the most important global transformations. Today, 12% of the world population is of age 60 and over and by the middle of this century this segment will represent 21.5%. The increase in population of those aged 80 and over, also referred to as the “oldest old” or the “very elderly”, will be even more pronounced, going from 1.7% of the population to 4.5% within the same period. Compared to European and North American countries, Latin America (LA) is experiencing this unprecedented demographic change at a significantly faster rate. Due to demographic and health transitions, the number of people with dementia will rise from 7.8 million in 2013 to over 27 million by 2050. Nowadays, the global prevalence of dementia in LA has reached 7.1%, with Alzheimer’s Disease (AD) being the most frequent type. This level is similar to those found in developed countries; however, the dementia rate is twice as high as that of the 65–69 years age group in developed countries. In addition, the prevalence and incidence of dementia is higher among illiterate people. Mortality rates due to dementia have risen considerably. The burden and costs of the disease are high and must be covered by patients’ families. The prevention of dementia and the development of longterm care policies and plans for people with dementia in LA, which take into account regional differences and similarities, should be urgent priorities.Item Systematic Review of the Diagnostic Validity of Brief Cognitive Screenings for Early Dementia Detection in Spanish-Speaking Adults in Latin America(2020) Custodio, Nilton; Duque, Lissette; Montesinos, Rosa; Alva-Díaz, Carlos; Mellado, Martin; Slachevsky, AndreaObjectives: The aim of this study was to evaluate the validity of brief cognitive screening (BCS) tools designed to diagnose mild cognitive impairment (MCI) or dementia in Spanish-speaking individuals over the age of 50 years from Latin America (LA). Methods: A systematic search of titles and abstracts in Medline, Biomed Central, Embase, Scopus, Scirus, PsycINFO, LILACS, and SciELO was conducted. Inclusion criteria were papers written in English or Spanish involving samples from Spanish-speaking Latin American individuals published until 2018. Standard procedures were applied for reviewing the literature. The data related to the study sample, methodology, and procedures applied, as well as the performance obtained with the corresponding BCS, were collected and systematized. Results: Thirteen of 211 articles met the inclusion criteria. The studies primarily involved memory clinic-based samples, with the exception of two studies from an adult day-care center, one from a primary care clinic, and one from a community-based sample. All the studies originated from five of the 20 countries of LA and all used standardized diagnostic criteria for the diagnosis of dementia and MCI; however, the diagnostic protocols applied differed. Most studies reported samples with an average of 10 years of education and only one reported a sample with an average of <5 years of education. No publication to date has included an illiterate population. Although the Montreal cognitive assessment (MoCA) is the most widely-used BCS tool in LA, it is significantly influenced by education level. Conclusions: Although evidence is still limited, the findings from studies on LA populations suggest that MoCA requires cultural adaptations and different cutoff points according to education level. Moreover, the diagnostic validity of the INECO frontal screening (IFS) test should be evaluated in populations with a low level of education. Given the heterogeneity that exists in the levels of education in LA, more studies involving illiterate and indigenous populations are required.Publication The BrainLat project, a multimodal neuroimaging dataset of neurodegeneration from underrepresented backgrounds(2023) Prado, Pavel; Medel, Vicente; Gonzalez, Raul; Sainz, Agustín; Vidal , Victor; Santamaría, Hernando; Moguilner, Sebastian; Mejia, Jhony; Slachevsky Chonchol, Andrea; Behrens, Maria; Aguillon, David; Lopera, Francisco; Parra, Mario; Matallana,Diana; Maito, Marcelo; Garcia, Adolfo; Custodio, Nilton; Ávila, Alberto; Piña, Stefanie; Birba, Agustina; Fittipaldi, Sol; Legaz, Agustina; Ibañez, AgustínThe Latin American Brain Health Institute (BrainLat) has released a unique multimodal neuroimaging dataset of 780 participants from Latin American. The dataset includes 530 patients with neurodegenerative diseases such as Alzheimer's disease (AD), behavioral variant frontotemporal dementia (bvFTD), multiple sclerosis (MS), Parkinson's disease (PD), and 250 healthy controls (HCs). This dataset (62.7 ± 9.5 years, age range 21-89 years) was collected through a multicentric effort across five Latin American countries to address the need for affordable, scalable, and available biomarkers in regions with larger inequities. The BrainLat is the first regional collection of clinical and cognitive assessments, anatomical magnetic resonance imaging (MRI), resting-state functional MRI (fMRI), diffusion-weighted MRI (DWI), and high density resting-state electroencephalography (EEG) in dementia patients. In addition, it includes demographic information about harmonized recruitment and assessment protocols. The dataset is publicly available to encourage further research and development of tools and health applications for neurodegeneration based on multimodal neuroimaging, promoting the assessment of regional variability and inclusion of underrepresented participants in research.Item The Multi-Partner Consortium to Expand Dementia Research in Latin America (ReDLat): Driving Multicentric Research and Implementation Science(2021) Ibáñez, Agustín; Yokoyama, Jennifer S.; Possin, Katherine L.; Matallana, Diana; Lopera, Francisco; Nitrini, Ricardo; Takada, Leonel T.; Custodio, Nilton; Sosa Ortiz, Ana Luisa; Avila-Funes, José Alberto; Behrens, María Isabel; Slachevsky, Andrea; Myers, Richard M.; Cochran, J. Nicholas; Brusco, Luis Ignacio; Bruno, Martin A.; Brucki, Sonia M. D.; Pina-Escudero, Stefanie Danielle; Oliveira, Maira Okada de; Donnelly Kehoe, Patricio; Santamaria-Garcia, Hernando; Moguilner, Sebastián; Tagliazucchi, Enzo; Maito, Marcelo; Longoria Ibarrola, Erika Mariana; Pintado-Caipa, Maritza; Godoy, Maria Eugenia; Bakman, Vera; Javandel, Shireen; Kosik, Kenneth S.; Valcour, Victor; Miller, Bruce L.; The Latin America the Caribbean Consortium on Dementia (LAC-CD)Dementia is becoming increasingly prevalent in Latin America, contrasting with stable or declining rates in North America and Europe. This scenario places unprecedented clinical, social, and economic burden upon patients, families, and health systems. The challenges prove particularly pressing for conditions with highly specific diagnostic and management demands, such as frontotemporal dementia. Here we introduce a research and networking initiative designed to tackle these ensuing hurdles, the Multi-partner consortium to expand dementia research in Latin America (ReDLat). First, we present ReDLat’s regional research framework, aimed at identifying the unique genetic, social, and economic factors driving the presentation of frontotemporal dementia and Alzheimer’s disease in Latin America relative to the US. We describe ongoing ReDLat studies in various fields and ongoing research extensions. Then, we introduce actions coordinated by ReDLat and the Latin America and Caribbean Consortium on Dementia (LAC-CD) to develop culturally appropriate diagnostic tools, regional visibility and capacity building, diplomatic coordination in local priority areas, and a knowledge-to-action framework toward a regional action plan. Together, these research and networking initiatives will help to establish strong cross-national bonds, support the implementation of regional dementia plans, enhance health systems’ infrastructure, and increase translational research collaborations across the continent.Item The power of knowledge about dementia in Latin America across health professionals working on aging(2020) Ibanez, Agustin; Flichtentrei, Daniel; Hesse, Eugenia; Dottori, Martin; Tomio, Ailin; Slachevsky, Andrea; Serrano, Cecilia M; Gonzalez-Billaut, Christian; Custodio, Nilton; Miranda, Claudia; Bustin, Julian; Cetckovitch, Marcelo; Torrente, Fernando; Olavarria, Loreto; Leon, Tomas; Costa Beber, Barbara; Bruki, Sonia; Suemoto, Claudia K.; Nitrini, Ricardo; Miller, Bruce L.; Yokoyama, Jennifer S.Methods: We investigated opinions among health professionals working on aging in LACs (N =3365) with regression models including expertise-related information (public policies, BI), individual differences (work, age, academic degree), and location. Results: Experts specified low public policy knowledge (X2 = 41.27, P < .001), high levels of stigma (X2 = 2636.37, P < .001), almost absent BI knowledge (X2 = 56.58, P < .001), and needs for regional diagnostic manuals (X2 = 2893.63, df = 3, P < .001) and data-sharing platforms (X2 = 1267.5, df = 3, P < .001). Lack of dementia knowledge was modulated by different factors. An implemented BI-based treatment for a proposed prevention program improved perception across experts. Discussion: Our findings help to prioritize future potential actions of governmental agencies and non-governmental organizations (NGOs) to improve LACs’ dementia knowledge.Publication Validation of Picture Free and Cued Selective Reminding Test for Illiteracy in Lima, Perú(2022) Montesinos, Rosa; Parodi, José; Díaz, Mónica; Herrera, Eder; Valeriano, Elizabeth; Soto, Ambar; Delgado, Carolina; Slachevsky Chonchol, Andrea; Custodio, NiltonDementia in Latin America is a crucial public health problem. Identifying brief cognitive screening (BCS) tools for the primary care setting is crucial, particularly for illiterate individuals. We evaluated tool performance characteristics and validated the free and total recall sections of the Free and Cued Selective Reminding Test-Picture version (FCSRT-Picture) to discriminate between 63 patients with early Alzheimer's disease dementia (ADD), 60 amnestic mild cognitive impairment (aMCI) and 64 cognitively healthy Peruvian individuals with illiteracy from an urban area. Clinical, functional, and cognitive assessments were performed. FCSRT-Picture performance was assessed using receiver operating characteristic curve analyses. The mean ± standard deviation scores were 7.7 ± 1.0 in ADD, 11.8 ± 1.6 in aMCI, and 29.5 ± 1.8 in controls. The FCSRT-Picture had better performance characteristics for distinguishing controls from aMCI compared with several other BCS tools, but similar characteristics between controls and early ADD. The FCSRT-Picture is a reliable BCS tool for illiteracy in Perú.