Globalising strategies to meet global challenges: the case of ageing and dementia

Parra, Mario A.; Butler, Stephen H.; McGeown, William J.; Nicholls, Louise A. Brown; Robertson, David J.

doi:10.7189/jogh.09.020310

Cited by 36 publications

(39 citation statements)

References 33 publications

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“…Recent reports highlight the unequal impact of diverse environmental factors on LACs 12,23 . There seems to be a consensus that available models of cognitive and brain reserve, which consider high educational levels, high intellectual functioning, and healthy lifestyles as their building blocks, 24 may not provide valid accounts to explain trajectories of cognitive aging in low and middle income countries (LMICs) 25 . Factors modulating cognitive reserve are poorly understood in the context of low educational levels 24 and limited access to socio‐educational programs.…”

Section: Knowledge Creationmentioning

confidence: 99%

Dementia in Latin America: Paving the way toward a regional action plan

Parra¹,

Báez²,

Sedeño³

et al. 2020

Alzheimer's & Dementia

121

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Across Latin American and Caribbean countries (LACs), the fight against dementia faces pressing challenges, such as heterogeneity, diversity, political instability, and socioeconomic disparities. These can be addressed more effectively in a collaborative setting that fosters open exchange of knowledge. In this work, the Latin American and Caribbean Consortium on Dementia (LAC‐CD) proposes an agenda for integration to deliver a Knowledge to Action Framework (KtAF). First, we summarize evidence‐based strategies (epidemiology, genetics, biomarkers, clinical trials, nonpharmacological interventions, networking, and translational research) and align them to current global strategies to translate regional knowledge into transformative actions. Then we characterize key sources of complexity (genetic isolates, admixture in populations, environmental factors, and barriers to effective interventions), map them to the above challenges, and provide the basic mosaics of knowledge toward a KtAF. Finally, we describe strategies supporting the knowledge creation stage that underpins the translational impact of KtAF.

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Section: Knowledge Creationmentioning

confidence: 99%

Dementia in Latin America: Paving the way toward a regional action plan

Parra¹,

Báez²,

Sedeño³

et al. 2020

Alzheimer's & Dementia

121

View full text Add to dashboard Cite

show abstract

“…Recent consensus papers try to address this by encouraging the use of biomarkers [27][28][29]. However, those papers acknowledge that while such methodologies become more widely available, better characterization of neuropsychological profiles will be necessary to enhance the reliability of clinical criteria [30].…”

Section: Introductionmentioning

confidence: 99%

Role of Executive Functions in the Conversion from Mild Cognitive Impairment to Dementia

Junquera

García-Zamora

Olazarán

et al. 2020

JAD

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Background: Recent research pointed to executive dysfunction as a potential early predictor of the progression of mild cognitive impairment (MCI) to dementia in Alzheimer’s clinical syndrome (ACS). Such cognitive impairments account for functional impairments in instrumental activities of daily living (IADL). Objective: The present study analyzes the contributions of executive functions to predict MCI–dementia progression in ACS. Methods: We assessed 145 participants, 51 cognitively unimpaired and 94 MCI. The latter were divided using the traditional, memory-based MCI classification (single domain amnestic, multidomain amnestic, and non-amnestic). Eight tests assessing executive functions were administered at baseline and at 1-year follow-up, together with cognitive screening tools and IADL measures. MCI patients were reclassified based on the outcomes from a K-mean cluster analysis which identified three groups. A simple lineal regression model was used to examine whether the classification based on executive functioning could more accurately predict progression to dementia a year later. Results: Clusters based on executive function deficits explained a significant proportion of the variance linked to MCI–dementia conversion, even after controlling for the severity of MCI at baseline (F(1, 68) = 116.25, p = 0.000, R2 = 0.63). Classical memory-based MCI classification failed to predict such a conversion (F(1, 68) = 5.09, p = 0.955, R2 = 0.07). Switching, categories generation, and planning were the executive functions that best distinguished between MCI converters and stable. Conclusion: MCI with a dysexecutive phenotype significantly predicts conversion to dementia in ACS a year later. Switching abilities and verbal fluency (categories) must be evaluated in MCI patients to assess risk of future dementia.

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“…There is currently an absence of national dementia strategies across these LMICs. Further, the lack of a culturally valid assessment tool for cognitive impairment, and the high cost of diagnostic imaging tools such as fluorodeoxyglucose (FDG)-positron emission tomography (PET) and Pittsburgh Compound-B (PIB) PET, are other challenges for research and diagnosis in LMICs [13-14]. Calia et al [13] explore the differences in the representation of dementia between people from the United States, United Kingdom, and China.…”

Section: Jogh-joghr Theme Issue On Global Dementiamentioning

confidence: 99%

“…They caution readers about the effect that these differences might have on the ways in which dementia is experienced and care is provided. Calia et al [13], Nitrini et al [7], Parra et al [14], Wang et al [15], and Watermeyer & Calia [16] discuss the cultural, educational, and linguistic biases in commonly used neuropsychological tools that are used for detecting cognitive impairments. They highlight the effect these issues have on research opportunities and clinical practice in non-English speaking and illiterate populations, especially in LMICs.…”

Section: Jogh-joghr Theme Issue On Global Dementiamentioning

confidence: 99%

“…Under sub-theme 2 (low-cost and efficient solutions), Watermeyer & Calia [16], Parra et al [14], Muniz-Terrera et al [17], and Danso et al [18] offer exciting insights into how new advances in neuropsychology, mobile technology, and data sciences (eg, speech and text analysis) can overcome language, educational, and cultural biases as well as problems with repeated measures embedded within established cognitive measures. These emerging tests and technologies also improve precision and sensitivity in the detection of pre-symptomatic Alzheimer’s disease.…”

Section: Jogh-joghr Theme Issue On Global Dementiamentioning

confidence: 99%

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