Biomarkers for dementia in Latin American countries: Gaps and opportunities

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.

Genuine high-order interactions in brain networks and neurodegeneration

“…Our results show promising evidence supporting applications of low-cost EEG in clinical settings, progressing in the international calls for cost-efficient biomarkers in dementia research (Dottori et al, 2017;Parra et al, 2021). In fact, the current international recommendations for research in our region (Latin America), suggest the development of affordable neuroimaging biomarkers potentially linked in the future to plasma biomarkers (Parra et al, 2022). Indeed, the large effect sizes, AUC values and related measures observed at networks of intermediate orders substantially outperformed what could be attained by traditional pairwise functional connectivity approaches in terms of parsimony and predictive power -for both unimodal and multimodal cases.…”

Classification of Alzheimer's disease and frontotemporal dementia using routine clinical and cognitive measures across multicentric underrepresented samples: a cross sectional observational study

“… 5 , 39 The data-driven techniques employed here provide a reliable approach to accurately discriminate between conditions, in a region known for exhibiting high clinical heterogeneity, having no systematic procedures for clinical assessment of dementia, and presenting limited access to biomarkers. 1 , 8 , 10 , 40 - 43 Additionally, the results add new evidence supporting complementary automatized methods for clinical discrimination of dementia. Such methods highlight the discriminative potential of measures of executive functioning, neuropsychiatric symptoms, and social cognition as compared to classical cognitive measures.…”

“… 1 , 8 , 9 Additionally, although methods that have been effective in high income countries (amyloid and tau PET imaging, and fluid-based biomarker assessment) could be effective solutions in the future, they currently are not widely available in LAC for both financial and logistic reasons, limiting their utility in informing clinical decisions. 1 , 10 Thus, developing methods to harmonise clinical, cognitive, and functional assessments is the most promising scalable approach available to diagnose AD and FTD in LAC. 9 …”

Model-based whole-brain perturbational landscape of neurodegenerative diseases

“…Neurodegenerative diseases and dementia represent an increasing social and economic burden to worldwide health ( GBD 2019 Dementia Forecasting Collaborators, 2022 ), with rising prevalence and incidence in countries with an aging population and specially across underrepresented populations from the developing world, where classical biomarkers and treatments are not yet massively available ( Hou et al, 2019 ; Mukadam et al, 2019 ; Parra et al, 2018 ; Parra et al, 2023 ). Alzheimer’s disease (AD) and behavioral variant frontotemporal dementia (bvFTD) are among the most prevalent neurodegenerative diseases, each linked to specific pathophysiology and to highly heterogeneous and atypical manifestation, hindering detection and diagnosis ( Musa et al, 2020 ; Parra et al, 2018 ).…”