Andrea María Slachevsky Conchol

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Slachevsky Chonchol, Andrea

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Slachevsky Chonchol

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Andrea María Slachevsky Conchol

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Factors associated with loneliness in Latin-American family care partners during the COVID-19 pandemic
(2024) Leon, Tomas; Tapia-Munoz, Thamara; Slachevsky Chonchol, Andrea; Costa Beber, Bárbara; Aguzzoli, Fernando; Nubia, Carla; Vilar-Compte, Mireya; Gaitan-Rossi, Pablo; Olavarria, Loreto; Castro, Loreto; Pinto, Alejandra; Guajardo, Tania; Grycuk, Emilia; Chen, Yaohua; Iracema Leroi, Iracema; Lawlor, Brian; Duran-Aniotz, Claudia; O’ Sullivan, Roger; Miranda-Castillo, Claudia; International Working Group
Background: COVID-19-related restrictions led to an increase in overall loneliness and social isolation. Before the pandemic, care partners reported higher levels of loneliness and higher loneliness prevalence compared to non-care partners. Because of the spread and severity of the infections, and the access to support spread, we expect a different impact of the COVID-19 pandemic on LATAM care partners. Objectives: To describe the loneliness levels of LATAM caregivers and to identify socioeconomic and health factors associated. Design: An international online cross-sectional survey for care partners, embedded within the ‘Coping with Loneliness and Isolation during COVID-19’ (CLIC) Study conducted between June 2020– and November 2020. Setting: We analysed data from 246 family care partners living in Latin American countries (46% Mexico, 26% Chile,18% Brazil, and 10% from Argentina, Peru, Venezuela, Panama, Guatemala y Costa Rica). Measurements: We assessed loneliness using the 6-items of De Jong Gierveld loneliness Scale. We described the levels of overall, emotional, and social loneliness pre and during Covid, and reported the distribution of care partners who improved, worsened or maintained their levels of loneliness. Moreover, we used longitudinal multiple linear regression models with bootstraps errors of 1,000 iterations to identify factors associated with the levels of overall, emotional, and social loneliness during the pandemic. Results: Participants were mostly women, 50 years and older, in a partnership, highly educated and with finances meeting their needs, with good to excellent physical and mental health. Among the total of care partners, 55% perceived higher overall loneliness, 56% higher emotional loneliness, and 21% higher social loneliness during the pandemic in comparison with pre-COVID-19 levels. Perceived mental health was associated with the overall, emotional, and social loneliness. Conclusions: Regardless of their living and health situation, during the pandemic, loneliness increased in all groups of care partners. These should be taken in consideration when planning public health approaches for crises such as pandemics or other large-scale disruptive events.
Automated free speech analysis reveals distinct markers of Alzheimer's and frontotemporal dementia
(2024) Lopes da Cunha, Pamela; Ruiz, Fabián; Ferrante, Franco; Sterpin, Lucas; Ibáñez, Agustín; Slachevsky Chonchol, Andrea; Matallana, Diana; Martínez, Ángela; Hesse, Eugenia; García, Adolfo
Dementia can disrupt how people experience and describe events as well as their own role in them. Alzheimer's disease (AD) compromises the processing of entities expressed by nouns, while behavioral variant frontotemporal dementia (bvFTD) entails a depersonalized perspective with increased third-person references. Yet, no study has examined whether these patterns can be captured in connected speech via natural language processing tools. To tackle such gaps, we asked 96 participants (32 AD patients, 32 bvFTD patients, 32 healthy controls) to narrate a typical day of their lives and calculated the proportion of nouns, verbs, and first- or third-person markers (via part-of-speech and morphological tagging). We also extracted objective properties (frequency, phonological neighborhood, length, semantic variability) from each content word. In our main study (with 21 AD patients, 21 bvFTD patients, and 21 healthy controls), we used inferential statistics and machine learning for group-level and subject-level discrimination. The above linguistic features were correlated with patients' scores in tests of general cognitive status and executive functions. We found that, compared with HCs, (i) AD (but not bvFTD) patients produced significantly fewer nouns, (ii) bvFTD (but not AD) patients used significantly more third-person markers, and (iii) both patient groups produced more frequent words. Machine learning analyses showed that these features identified individuals with AD and bvFTD (AUC = 0.71). A generalizability test, with a model trained on the entire main study sample and tested on hold-out samples (11 AD patients, 11 bvFTD patients, 11 healthy controls), showed even better performance, with AUCs of 0.76 and 0.83 for AD and bvFTD, respectively. No linguistic feature was significantly correlated with cognitive test scores in either patient group. These results suggest that specific cognitive traits of each disorder can be captured automatically in connected speech, favoring interpretability for enhanced syndrome characterization, diagnosis, and monitoring.
Author Correction: Neurocognitive correlates of semanticmemory navigation in Parkinson’s disease
(2024) Toro, Felipe; Migeot, Joaquín; Marchant, Nicolás; Olivares, Daniela; Ferrante, Franco; González, Raúl; González, Cecilia; Fittipaldi, Sol; Rojas, Gonzalo; Moguilner, Sebastian; Slachevsky Chonchol, Andrea; Chaná, Pedro; Ibáñez, Agustín; Chaigneau, Sergio; García, Adolfo
Correction to: npj Parkinson’s Disease https://doi.org/10.1038/ s41531-024-00630-4, published online 9 January 2024. In this article the funding from ‘Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile, #BL-SRGP2021-01’ for author Adolfo M. García was omitted. The original article has been corrected.
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, Agustín
Background 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.
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
(2024) Olavarría, Loreto; Caramelli, Paulo; Lema, José; Bezerra, Caíssa; Pinto, Alejandra; Dos Santos, Lílian; Thumala, Daniela; Santos, Maria; Peredo, Adriana; Barroso, Alana; Carvalho, Karoline; Sepúlveda, Walter; Cardoso, Ludmilla; Tonidandel, Maira; Slachevsky Chonchol, Andrea
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.
Standardization and diagnostic utility of the Frontal Assessment Battery for healthy people and patients with dementia in the Chilean population
(2022) Grandi, Fabrissio; Martínez, David; Parra, Mario; Olavarria, Loreto; Huepe, David; Alegría, Patricia; Aliaga, Álvaro; Lillo, Patricia; Delgado, Carolina; Tenorio, Marcela; Rosas, Ricardo; López, Oscar; Becker, James; Slachevsky Chonchol, Andrea
The Frontal Assessment Battery (FAB) is a screening test that measures executive functions. Although this instrument has been validated in several countries, its diagnostic utility in a Chilean population has not been studied yet. Objectives: This study aimed to (1) adapt FAB in a Chilean population; (2) study the psychometric properties of the FAB in a Chilean population; (3) assess the sociodemographic influence in the performance of the FAB in a sample of healthy controls (HC); and (4) develop normative data for this healthy group. Methods: A HC (n=344) and a group of patients with dementia (n=156) were assessed with the Chilean version of FAB. Results: FAB showed good internal consistency (Cronbach's alpha=0.79) and acceptable validity based on the relationship with other variables. Factor analysis showed the unidimensionality of the instrument. Significant differences were found in the total FAB value between the HC and dementia groups. With the matched sample, the established cutoff point was 13.5, showing a sensitivity of 80.8% and a specificity of 90.4%. Regression analysis showed that education and age significantly predicted FAB performance in the healthy group. Finally, normative data are provided. Conclusions: This study shows that FAB is a useful tool to discriminate between healthy people and people with dementia. However, further studies are needed to explore the capacity of the instrument to characterize the dysexecutive syndrome in people with dementia in the Chilean population.
Comprehensive Analysis of Genetic Contributions to Alzheimer’s Disease and Frontotemporal Dementia in Admixed Latin American Populations
(2024) Acosta, Juliana; Pina, Stefanie; Cochran, Nicholas; Taylor, Jared; Warly, Caroline; Matallana, Diana; Tadao, Leonel; Bruno, Martin; Levine, Alexandra; George, Dawwod; Lopera, Francisco; Slachevsky Chonchol, Andrea; Behrens, María; Ávila, José; Zapata, Lina; Brusco, Luis; Custodio, Nilton; Ramos, Teresita; Bruna, Bárbara; Ponce, Daniela; Gelvez, Nancy; Lopez, Greizy; Gomez, Luisa; Buitrago, Carlos; Reyes, Pablo; Durón, Dafne; Pantazis, Caroline; Maito, Marcelo; Javandel, Shireen; Godoy, Maria; Bistue, Maria; Vitale, Dan; Nalls, Mike; Singleton, Andrew; Miller, Bruce; Ibáñez, Agustín; Kosik, Kenneth; Yokoyama, Jennifer; Montesinos, Rosa; França, Elisa de Paula; Multi-Partner Consortium to Expand Dementia Research in Latin America (ReDLat)
Background: Most research initiatives have emerged from high-income countries (HIC), leaving a gap in understanding the disease’s genetic basis in diverse populations like those in Latin American countries (LAC). ReDLat tackles this gap, focusing on LAC’s unique genetics and socioeconomic factors to identify specific Alzheimer’s Disease (AD) and Frontotemporal Dementia (FTD) risk factors in Mexico, Colombia, Peru, Chile, Argentina, and Brazil. Method: We employed a comprehensive genetic analysis approach, integrating Whole Genome Sequencing (WGS), Exome Sequencing, and SNP arrays to understand the cohort’s unique genetic architecture.We conducted ancestry analysis and searched for disease-causing variants with mendelian inheritance, genome-wide association studies (GWAS), rare variant enrichment, and evaluation of Polygenic Risk Scores (PRS). Results: We recruited and genotyped an initial cohort of 1046 participants with AD, 423 with FTD, and 855 healthy controls (HC) between 2020 and 2023. Analysis is ongoing, and we expect to sequence ∼600 additional samples in the coming months. Ancestry analysis revealed tri-continental admixture, except for Brazil, which showed an additional Asian component (Figure 1). Top candidate gene rare variant enrichment associations (SKAT p < 0.05) were TREM2 for FTD and ABCA7 and ABCA1 for AD. GWAS identified a robust association with the APOE locus on chromosome 19 in AD vs. HC.. We tested an AD PRS developed in European populations by Bellenguez et al (2020). on our cohort using 83 single-nucleotide polymorphisms.. The PRS modestly distinguishes between all patients and HC (p = 2.4 × 10ˆ-12), AD vs. HC (p = 2.2 × 10ˆ-12), and even FTD vs. HC (p = 4.3 × 10ˆ-5), albeit with modest separation between groups, as expected for its application in a genetically admixed population. Conclusion: Our findings represent a pivotal step in understanding the genetic landscape of AD and FTD in admixed populations. They underscore the importance of including diverse populations in genetic research, paving the way for future studies. These findings have the potential to inform more personalized approaches to the diagnosis and treatment of neurodegenerative diseases in diverse global populations, as well as identify novel targets for therapeutic development
Gaps in biomedical research in frontotemporal dementia: A call for diversity and disparities focused research
(2024) Nuytemans, Karen; Franzen, Sanne; Broce, Iris J.; Caramelli, Paulo; Ellajosyula, Ratnavalli; Finger, Elizabeth; Gupta, Veer; Gupta, Vivek; Illán-Gala, Ignacio; Loi, Samantha M.; Morhardt, Darby; Pijnenburg, Yolande; Rascovsky, Katya; Williams, Monique M.; Yokoyama, Jennifer S.; Acosta-Uribe, Juliana; Akinyemi, Rufus; Alladi, Suvarna; Ayele, Biniyam A.; Ayhan, Yavuz; Bourdage, Renelle; Castro-Suarez, Sheila; Cruz de Souza, Leonardo; Dacks, Penny; Boer, Sterre C. M. de; Leon, Jessica de; Dodge, Shana; Grasso, Stephanie; Ghoshal, Nupur; Kamath, Vidyulata; Kumfor, Fiona; Matias-Guiu, Jordi A.; Narme, Pauline; Nielsen, T. Rune; Okhuevbie, Daniel; Piña-Escudero, Stefanie; Ruiz-Garcia, Ramiro; Ryan, Brigid; Scarioni, Marta; Slachevsky Chonchol, Andrea; Suarez-Gonzalez, Aida; Lead Tee, Boon; Tsoy , Elena; Ulugut, Hulya; Chiadi U Onyike, Chiadi U.; Babulal, Ganesh M.; ISTAART Frontotemporal Dementia and Related Disorders PIA; ISTAART Diversity and Disparities PIA
Frontotemporal dementia (FTD) is one of the leading causes of young-onset dementia before age 65, typically manifesting as abnormal behavior (in behavioral variant FTD) or language impairment (in primary progressive aphasia). Although FTD affects all populations across the globe, knowledge regarding the pathophysiology and genetics derives primarily from studies conducted in North America and Western Europe. Globally, biomedical research for FTD is hindered by variable access to diagnosis, discussed in this group's earlier article, and by reduced access to expertise, funding, and infrastructure. This perspective paper was produced by two professional interest areas of the Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment (ISTAART) and discusses the field's current status on the cross-cultural aspects of basic and translational research in FTD (including that focused on epidemiology, genetics, biomarkers, and treatment). It subsequently provides a summary of gaps and needs to address the disparities and advance global FTD biomedical research.
Rehabilitation Services for Young-Onset Dementia: Examples from High- and Low-Middle-Income Countries
(2024) Suárez, Aida; Savage, Sharon; Alladi, Suvarna; Carvalho, Viviane; Arshad, Faheem; Camino, Julieta; Caramelli, Paulo; Comas, Adelina; Cook, Julia; Cooper, Claudia; García, Laura; Grasso, Stephanie; Jokel, Regina; Lavoie, Monica; León, Tomás; Priya, Thomas; Ramos, Teresita; Taylor, Cathleen; Townsend, Rosemary; Thöne, Angelika; Slachevsky Chonchol, Andrea; Volkmer, Anna; Weidner, Wendy; Mc O'Connor, Claire
The WHO Dementia Global Action Plan states that rehabilitation services for dementia are required to promote health, reduce disability, and maintain quality of life for those living with dementia. Current services, however, are scarce, particularly for people with young-onset dementia (YOD). This article, written by an international group of multidisciplinary dementia specialists, offers a three-part overview to promote the development of rehabilitation services for YOD. Firstly, we provide a synthesis of knowledge on current evidence-based rehabilitative therapies for early-onset Alzheimer's disease (EOAD), behavioural variant frontotemporal dementia (bvFTD), primary progressive aphasia (PPA), and posterior cortical atrophy (PCA). Secondly, we discuss the characteristics of rehabilitation services for YOD, providing examples across three continents for how these services can be embedded in existing settings and the different roles of the rehabilitation multidisciplinary team. Lastly, we conclude by highlighting the potential of telehealth in making rehabilitation services more accessible for people with YOD. Overall, with this paper, we aim to encourage clinical leads to begin introducing at least some rehabilitation into their services, leveraging existing resources and finding support in the collective expertise of the broader multidisciplinary dementia professional community.
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, Agustín
The 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.