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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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.
Author Correction: the BrainLat project, a multimodal neuroimaging dataset of neurodegeneration from underrepresented backgrounds
(2024) Prado, Pavel; Medel, Vicente; González, Raúl; Sainz, Agustín; Vidal, Víctor; Santamaría, Hernando; Moguilner, Sebastián; Mejía, Jhony; Slachevsky Chonchol, Andrea; Behrens, Maria Isabel; Aguillón, David; Lopera, Francisco; Parra, Mario; Matallana, Diana; Adrián, Marcelo; García, Adolfo; Custodio, Nilton; Ávila, Alberto; Piña, Stefanie; Birba, Agustina; Fittipaldi, Sol; Legaz, Agustina; Ibáñez, Agustín
In this article the author name Maria Isabel Behrens was incorrectly written as Maria Isabel Beherens. The original article has been corrected.
Gaps in clinical research in frontotemporal dementia: A call for diversity and disparities-focused research
(2023) Franzen, Sanne; Nuytemans, Karen; Bourdage, Renelle; Caramelli, Paulo; Ellajosyula, Ratnavalli; Finger, Elizabeth; Illán-Gala, Ignacio; Loi, Samantha M.; Morhardt, Darby; Pijnenburg, Yolande; Rascovsky, Katya; Williams, Monique M.; Yokoyama, Jennifer S.; Alladi, Suvarna; Ayhan, Yavuz; Broce, Iris; Castro-Suarez, Sheila; Coleman, Kristy; Cruz de Souza, Leonardo; Dacks, Penny A.; Boer, Sterr C. M. de; Leon, Jessica de; Dodge, Shana; Grasso, Stephanie; Gupta, Veer; Gupta, Vivek; Ghoshal, Nupur; Kamath, Vidyulata; Kumfor, Fiona; Matias-Guiu, Jordi A.; Narme, Pauline; Nielsen, Rune; Okhuevbie, Daniel; Piña-Escudero, Stefanie D.; Ruiz Garcia, Ramiro; Scarioni, Marta; Slachevsky Chonchol, Andrea; Suarez-Gonzalez, Aida; Lead Tee, Boon; Tsoy, Elena; Ulugut, Hülya; Babulal, Ganesh M.; Onyike, Chiadi U.
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.
Educational disparities in brain health and dementia across Latin America and the United States
(2024) Gonzalez, Raul; Legaz, Agustina; Moguilner, Sebastián; Cruzat, Josephine; Hernández, Hernán; Baez, Sandra; Cocchi, Rafael; Coronel, Carlos; Medel,Vicente; Tagliazuchi, Enzo; Migeot, Joaquín; Ochoa, Carolina; Maito, Marcelo; Reyes, Pablo; Santamaria, Hernando; Godoy, Maria; Javande, Shireen; García, Adolfo; Matallana, Diana; Avila, José; Slachevsky Chonchol, Andrea; Behrens, María; Custodio, Nilton; Cardona, Juan; Brusco, Ignacio; Bruno, Martín; Sosa, Ana; Pina, Stefanie; Takada, Leonel; França, Elisa; Valcour, Victor; Possin, Katherine; De Oliveira, Maira; Lopera, Francisco; Lawlor, Brian; Hu, Kun; Miller, Bruce; Yokoyama, Jennifer; Gonzalez, Cecilia; Ibañez, Agustin
Background: Education influences brain health and dementia. However, its impact across regions, specifically Latin America (LA) and the United States (US), is unknown. Methods: A total of 1412 participants comprising controls, patients with Alzheimer's disease (AD), and frontotemporal lobar degeneration (FTLD) from LA and the US were included. We studied the association of education with brain volume and functional connectivity while controlling for imaging quality and variability, age, sex, total intracranial volume (TIV), and recording type. Results: Education influenced brain measures, explaining 24%-98% of the geographical differences. The educational disparities between LA and the US were associated with gray matter volume and connectivity variations, especially in LA and AD patients. Education emerged as a critical factor in classifying aging and dementia across regions. Discussion: The results underscore the impact of education on brain structure and function in LA, highlighting the importance of incorporating educational factors into diagnosing, care, and prevention, and emphasizing the need for global diversity in research. Highlights: Lower education was linked to reduced brain volume and connectivity in healthy controls (HCs), Alzheimer's disease (AD), and frontotemporal lobar degeneration (FTLD). Latin American cohorts have lower educational levels compared to the those in the United States. Educational disparities majorly drive brain health differences between regions. Educational differences were significant in both conditions, but more in AD than FTLD. Education stands as a critical factor in classifying aging and dementia across regions.
A Multidimensional, Person-Centered Framework for Functional Assessment in Dementia: Insights from the 'What', 'How', 'To Whom', and 'How Much' Questions
(2024) Slachevsky Chonchol, Andrea; Grandi, Fabrissio; Thumala, Daniela; Baez, Sandra; Santamaria, Hernando; Schmitter, Maureen; Parra, Mario
Dementia is a syndrome characterized by cognitive and neuropsychiatric symptoms associated with progressive functional decline (FD). FD is a core diagnostic criterion for dementia, setting the threshold between its prodromal stages and the full-blown disease. The operationalization of FD continues to generate a great deal of controversy. For instance, the threshold of FD for the diagnosis of dementia varies across diagnostic criteria, supporting the need for standardization of this construct. Moreover, there is a need to reconsider how we are measuring FD to set boundaries between normal aging, mild cognitive impairment, and dementia. In this paper, we propose a multidimensional framework that addresses outstanding issues in the assessment of FD: i) What activities of daily living (ADLs) are necessary to sustain an independent living in aging? ii) How to assess FD in individuals with suspected neurocognitive disorders? iii) To whom is the assessment directed? and iv) How much does FD differentiate healthy aging from mild and major neurocognitive disorders? Importantly, the To Whom Question introduces a person-centered approach that regards patients and caregivers as active agents in the assessment process of FD. Thus, once impaired ADLs have been identified, patients can indicate how significant such impairments are for them in daily life. We envisage that this new framework will guide future strategies to enhance functional assessment and treatment of patients with dementia and their caregivers.
Functional Capacity in Activities of Daily Living in the Alzheimer’s Disease Continuum
(2024) Henriquez, Fernando; Domínguez, Carmen; Grandi, Fabrissio; Gonzalez, Cecilia; Riquelme, Patricio; Lillo, Patricia; Martínez, David; Thumala, Daniela; Henriquez, Rodrigo; Aboitiz, Francisco; Slachevsky Chonchol, Andrea
Background The most common and prevalent dementia worldwide is Alzheimer’s disease (AD). AD is a continuum composed of Subjective Cognitive Impairment (SCD), Mild Cognitive Impairment (MCI), and Alzheimer’s Disease dementia (ADD) stage. One of the main clinical variables in patients with dementia is performance in functional capacity since its alterations are associated with poor prognosis and disease progression. Functional capacity is measured through activities of daily living (ADL), which are divided into three domains: i) Basic (BADL), ii) Instrumental (IADL), and iii) Advanced (AADL). The study aimed to characterize the performance of the different stages of the AD continuum in the ADL domains and their association with cognitive abilities. Method A cross-sectional study of subjects at different stages of the AD continuum was conducted: Healthy Controls (CTR) (n = 17), SCD (n = 77), MCI (n = 30), and ADD (n = 23), who were matched for age, sex, and education. ADLs were estimated using The Technology-Activities of Daily Living Questionnaire (T-ADLQ), which assesses the three domains and a total score. T-ADLQ performance was compared across groups and correlated with cognitive ability instruments (ACE-III and IFS). Result The results showed that patients with ADD performed worse on the BADL, IADL, and total ADLs compared to the other three groups. There were no significant differences between the CTR, SCD, and MCI on the BADL, IADL, and total ADLs. However, the AADL, in addition to differentiating the ADD patients from the other three groups, also showed differences between CTR and MCI subjects and between SCD and MCI subjects (Table 1 and Figure 1). The correlation study showed that AADL correlated significantly with global cognitive and executive function assessment (Figure 2). Conclusion AADL shows progressive functional impairment at different stages of the AD continuum, which is further associated with global cognitive and executive function performances. As one progresses to a more advanced stage of the disease continuum, the performance of ADLs, especially AADLs, worsens, which could indicate a marker of disease progression, allowing for better patient follow-up.
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.
Neurocognitive correlates of semantic memory 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
Cognitive studies on Parkinson's disease (PD) reveal abnormal semantic processing. Most research, however, fails to indicate which conceptual properties are most affected and capture patients' neurocognitive profiles. Here, we asked persons with PD, healthy controls, and individuals with behavioral variant frontotemporal dementia (bvFTD, as a disease control group) to read concepts (e.g., 'sun') and list their features (e.g., hot). Responses were analyzed in terms of ten word properties (including concreteness, imageability, and semantic variability), used for group-level comparisons, subject-level classification, and brain-behavior correlations. PD (but not bvFTD) patients produced more concrete and imageable words than controls, both patterns being associated with overall cognitive status. PD and bvFTD patients showed reduced semantic variability, an anomaly which predicted semantic inhibition outcomes. Word-property patterns robustly classified PD (but not bvFTD) patients and correlated with disease-specific hypoconnectivity along the sensorimotor and salience networks. Fine-grained semantic assessments, then, can reveal distinct neurocognitive signatures of PD.
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.
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, Nilton
Dementia 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.