ABSTRACT
INTRODUCTION: While Latin America (LatAm) is facing an increasing burden of dementia due to the rapid aging of the population, it remains underrepresented in dementia research, diagnostics, and care. METHODS: In 2023, the Alzheimer's Association hosted its eighth satellite symposium in Mexico, highlighting emerging dementia research, priorities, and challenges within LatAm. RESULTS: Significant initiatives in the region, including intracountry support, showcased their efforts in fostering national and international collaborations; genetic studies unveiled the unique genetic admixture in LatAm; researchers conducting emerging clinical trials discussed ongoing culturally specific interventions; and the urgent need to harmonize practices and studies, improve diagnosis and care, and use affordable biomarkers in the region was highlighted. DISCUSSION: The myriad of topics discussed at the 2023 AAIC satellite symposium highlighted the growing research efforts in LatAm, providing valuable insights into dementia biology, genetics, epidemiology, treatment, and care.
Subject(s)
Dementia , Humans , Dementia/therapy , Dementia/diagnosis , Dementia/genetics , Dementia/epidemiology , Latin America/epidemiology , Mexico/epidemiology , Alzheimer Disease/therapy , Alzheimer Disease/diagnosis , Alzheimer Disease/genetics , Biomedical Research , Congresses as TopicABSTRACT
In the growing body of literature dealing with the consequences of family caregiving amongst people with dementia, there are few studies examining the impact of Early-onset Familial Alzheimer's Disease on caregivers. This study exposes the subjective experience of a group of family caregivers who themselves possess a genetic susceptibility to develop this form of dementia. We interviewed and analyzed the accounts of 27 caregivers belonging to family lineages carrying the E280A mutation for Early-onset Alzheimer's Disease. We utilized a phenomenological method to analyze these accounts, initially tracking seven theoretical categories (Anxiety, Depression, Burden, Resilience, Self-efficacy, Social Support, and Coping Strategies) and then subsequently two additional categories which emerged (Conceptions about the Disease and Other Vital Experiences Interfering with Caregiving). The results show that caring for a loved one while simultaneously running the risk of developing the same form of Alzheimer's Disease permeates the caregivers' experience both in a negative and a positive way. The continuous exposition to emotional stress in these caregivers should be seriously considered as they may be at risk of accelerating the onset of symptoms of Alzheimer's Disease, while simultaneously, early psychological symptoms of dementia may be masked by the emotional sequelae of caregiving, interfering with early diagnosis. Certainly, support services for the entire family group are suggested.
Subject(s)
Adaptation, Psychological , Alzheimer Disease/genetics , Caregivers/psychology , Narration , Resilience, Psychological , Stress, Psychological/psychology , Adult , Female , Humans , Interviews as Topic , Male , Middle Aged , Mutation/genetics , Social SupportABSTRACT
Dynamic causal modeling (DCM) is a framework for making inferences about changes in brain connectivity using neuroimaging data. We fitted DCMs to high-density EEG data from subjects performing a semantic picture matching task. The subjects are carriers of the PSEN1 mutation, which leads to early onset Alzheimer's disease, but at the time of EEG acquisition in 1999, these subjects were cognitively unimpaired. We asked 1) what is the optimal model architecture for explaining the event-related potentials in this population, 2) which connections are different between this Presymptomatic Carrier (PreC) group and a Non-Carrier (NonC) group performing the same task, and 3) which network connections are predictive of subsequent Mini-Mental State Exam (MMSE) trajectories. We found 1) a model with hierarchical rather than lateral connections between hemispheres to be optimal, 2) that a pathway from right inferotemporal cortex (IT) to left medial temporal lobe (MTL) was preferentially activated by incongruent items for subjects in the PreC group but not the NonC group, and 3) that increased effective connectivity among left MTL, right IT, and right MTL was predictive of subsequent MMSE scores.
Subject(s)
Alzheimer Disease/diagnosis , Alzheimer Disease/physiopathology , Brain/physiopathology , Electroencephalography/methods , Signal Processing, Computer-Assisted , Adult , Alzheimer Disease/genetics , Alzheimer Disease/psychology , Bayes Theorem , Cognition , Evoked Potentials , Genes, Dominant , Genetic Predisposition to Disease , Heterozygote , Humans , Mental Status and Dementia Tests , Middle Aged , Neural Pathways/physiopathology , Presenilin-1/genetics , Prodromal Symptoms , Young AdultABSTRACT
INTRODUCTION: Patients suffering clinical dementia caused by Alzheimer's disease have a high risk of developing malnutrition caused by all the physiological, socio-economic and psychological changes related to the disease, together with the ageing process. OBJECTIVE: To describe the nutritional condition of a group of patients with Alzheimer's dementia according to the degree of disease severity. Patients were selected from the University of Antioquia Neurosciences Group. MATERIALS AND METHODS: Descriptive cross sectional study. Patients were assessed and information was collected about their body composition, food consumption behaviour, clinical, and psychosocial variables. RESULTS: 77 patients were studied; their mean age was 65, 5 +/- 12.8 years. 48 had a family history of Alzheimer's disease; 39 were diagnosed more than 60 months before the study started; the most frequently found degree of severity was moderate, the most common type of dementia was the early family form. 26 began the disease process before they were 50 years old. Significant differences for Body Mass Index, brachial adipose area and brachial lean area were found (p = 0.001, p = 0.000, p = 0.000, respectively) between patients with the different degrees of disease severity. These parameters measures were lowest in patients with severe disease. The intake of calcium and folate was the lowest amongst the nutrients studied. CONCLUSION: The nutritional state is impaired in patients suffering Alzheimer's dementia from the early stages of the disease. The most important nutritional and clinical abnormalities found were depletion of the lean and fat stores, low intake of calcium and folate and clinical signs of the disease. Changes in these parameters worsen as the disease progresses.
Subject(s)
Alzheimer Disease/physiopathology , Nutritional Status , Aged , Aged, 80 and over , Body Composition , Body Mass Index , Cross-Sectional Studies , Eating , Female , Humans , Male , Malnutrition , Middle Aged , Neurosciences , Nutrition Assessment , Surveys and QuestionnairesABSTRACT
Introducción. Los pacientes con demencia tipo Alzheimer presentan riesgo de deterioro del estado nutricional por cambios fisiológicos, socioeconómicos y psicológicos relacionados con la enfermedad, lo que se suma al proceso de envejecimiento. Objetivo. Describir el estado nutricional de los pacientes con demencia tipo Alzheimer del Grupo de Neurociencias de la Universidad de Antioquia según el estadio de evolución. Materiales y métodos. Estudio descriptivo transversal. Cada paciente fue evaluado para obtener información general, de salud, composición corporal, alimentaria, signos clínicos y aspectos psicosociales. Resultados. Se evaluaron 77 pacientes con edad promedio de 65,5±12,8 años, 48 de ellos con antecedentes familiares de la enfermedad y 39 con más de 60 meses de diagnóstico; el estadio más frecuente fue el moderado y el tipo de demencia más común, la familiar precoz; la enfermedad se diagnosticó antes de los 50 años en 26 pacientes. Hubo diferencias estadísticamente significativas en el índice de masa corporal, el área grasa braquial y el área magra braquial por estadio, y mayor compromiso en el estadio grave ( p=0,001, p=0,000 y p=0,000); en todos los estadios se presentó compromiso de la reserva energética y muscular. El calcio y los folatos fueron los nutrientes más comprometidos en el consumo. Conclusión. Aun en el estadio inicial, los pacientes presentaron compromiso del estado nutricional, evidenciado por déficit en la reserva energética y muscular, signos clínicos y consumo inadecuado de calcio y folatos. A medida que avanza la enfermedad, el compromiso de los indicadores nutricionales es mayor. Lo anterior evidencia la necesidad del cuidado nutricional individual de acuerdo con el estadio de la enfermedad.
