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  • 1
    In: Alzheimer's & Dementia, Wiley, Vol. 18, No. S11 ( 2022-12)
    Abstract: Vascular dementia is the second most common cause of dementia. Brain health is defined as the capacity to function adaptively in the environment, and its partially determined by cardiovascular risk factors, which are a potential target for the prevention of all cause dementia. We developed a brain health index (BHI) to establish association with possible vascular cognitive impairment. Method MHAS is a longitudinal cohort study of Mexican adults ≥50 years. The cardiovascular risk factors (CVRF) considered for the index were: diabetes, hypertension, myocardial infarction, depression, obesity, physical inactivity and smoking. pVCI was defined if scores in two or more cognitive domains in the Cross‐Cultural Cognitive Examination were ≥1.5 standard deviations below the mean on reference norms for self‐respondents or for proxy respondents a score ≥3.4 on the Informant Questionnaire on Cognitive Decline in the Elderly, with limitations in ≥1 instrumental activities of daily living and a history of stroke. A cognitive unimpaired and dementia without stroke groups were included. We compared the groups with ANOVA; a multinomial regression model was developed to predict the association of the BHI with the groups and a Cox regression model to determine Result 12,427 individuals were included, 513 were identify as dementia without stroke and 75 as pVCI. For pVCI, 57.3% were female, with mean age of 75.28 (SD 9.31) years and education of 3.25 (SD 4.75) years. The mean BHI for the cohort was 2.21 (SD 1.27), for dementia without stroke 2.79 (SD 1.17), and with pVCI 3.28 (SD 1.23). The OR for pVCI was 1.904 (CI 1.4‐2.6, p 〈 0.001) and the HR with a 3 year follow‐up was 1.75 (CI 1.4‐2.17, p 〈 0.001). Conclusion The BHI predicted the development of pVCI up to 74.5% in the 3 year follow‐up after adjusting for covariables. This index could potentially be used to identify pVCI in adults with potentially modifiable CVRF. Further studies should be carried out in other populations and with longer follow‐ups.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2201940-6
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  • 2
    Online Resource
    Online Resource
    FapUNIFESP (SciELO) ; 2007
    In:  Salud Pública de México Vol. 49, No. 4 ( 2007-08), p. 256-262
    In: Salud Pública de México, FapUNIFESP (SciELO), Vol. 49, No. 4 ( 2007-08), p. 256-262
    Type of Medium: Online Resource
    ISSN: 0036-3634
    Language: English
    Publisher: FapUNIFESP (SciELO)
    Publication Date: 2007
    detail.hit.zdb_id: 2060310-1
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  • 3
    Online Resource
    Online Resource
    FapUNIFESP (SciELO) ; 2007
    In:  Salud Pública de México Vol. 49 ( 2007), p. s467-s474
    In: Salud Pública de México, FapUNIFESP (SciELO), Vol. 49 ( 2007), p. s467-s474
    Type of Medium: Online Resource
    ISSN: 0036-3634
    Language: English
    Publisher: FapUNIFESP (SciELO)
    Publication Date: 2007
    detail.hit.zdb_id: 2060310-1
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  • 4
    In: Alzheimer's & Dementia, Wiley, Vol. 16, No. S5 ( 2020-12)
    Abstract: Cerebral tractography is a Magnetic Resonance Imaging technique that allows you to visualize the white matter fascicles that connect different parts of the brain. It is based on the diffusion of water in biological tissues, through which fiber tracts are evaluated in a three‐dimensional space, which allows to obtain the Anisotropy Fraction (FA) and Medium Diffusivity (DM). Tractography allows correlating the integrity of these pathways with cognitive function. The objective of our study was to identify anatomical regions with alterations in AF in mixed dementia compared to AD. Method 16 patients were included; 8 with Mixed Dementia (DMix) and 8 with Alzheimer's Disease (AD). Mean, standard deviations and frequencies were used, as well as Chi‐square and Mann‐Whitney tests. A linear regression model was used to determine the association between Tractography and performance in cognitive domains, adjusted for age and educational level. Results The mean age of the participants was 85 ± 7.9 years (p ≤.57), 69% were women (p ≤.10) and the educational level was 11 ± 6.0 years (p ≤.87). Participants with AD had a worse cognitive performance (NEUROPSI: 68.5 ± 11.6 points, p ≤.02) compared to the DMix group. When analyzing by cognitive domains, patients in the DMix group had a worse performance in phonological verbal fluency (7.0 ± 3.5 words, p ≤.05). Regarding neuroimaging, significant differences were observed in participants with DMix in the Anisotropy Fraction (AF) in the following tracts: right cerebral peduncle (0.5557 ± 0.0121, p ≤.05), left cerebral peduncle (0.5476 ± 0.0121, p ≤0.01), right external capsule (0.3346 ± 0.0163, p ≤0.01) and left cingulate gyrus (0.3756 ± 0.0241, p ≤0.05) and mean diffusivity in the right thalamic posterior radiation (0.0010 ± 0.0000, p ≤ 0.03) and left external capsule (0.0012 ± 0.0001, p ≤0.03). Conclusion Tractography allows quantifying and differentiating anatomical regions with myelin damage in mixed dementia compared to AD.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2201940-6
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  • 5
    In: Alzheimer's & Dementia, Wiley, Vol. 17, No. S10 ( 2021-12)
    Abstract: In the COVID‐19 pandemic, older adults from vulnerable ethnoracial groups are at high risk of infection, hospitalization, and death. We aimed to explore the pandemic’s impact on the well‐being and cognition of older adults within and outside of the United States (US). Method 1,747 (646 White, 991 Latino, 77 Black, 33 Asian; 72% female) individuals from the US and 14 Latin American countries completed an online survey regarding well‐being and cognition during the pandemic. Outcome variables (pandemic impact, discrimination, loneliness, purpose of life, subjective cognitive concerns) were compared across four US ethnoracial groups, and Latinos living in the US and Latin America. Result Mean age was 66·5 ( SD = 7·70) years and mean education was 15·4 ( SD = 2·76) years. We found no differences in the pandemic’s overall impact across US ethnoracial groups. Compared to Whites, Latinos reported greater economic impact ( p 〈 ·001, η p 2 = .031); while Blacks reported experiencing discrimination more often ( p 〈 ·001, η p 2 = .050). Blacks and Latinos reported more positive coping ( p 〈 ·001, η p 2 = 040). Latin American Latinos reported greater pandemic impact ( p 〈 ·001, η p 2 =.013 ), more positive coping ( p =·006, η p 2 =.008 ), and less discrimination than US Latinos ( p 〈 ·001, η p 2 = .013 ). Conclusion The COVID‐19 pandemic has differentially impacted the well‐being of older ethnically diverse individuals in the US and Latin America. Future studies should examine how mediators like income and coping skills modify the pandemic’s impact.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2201940-6
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  • 6
    In: Alzheimer's & Dementia, Wiley, Vol. 18, No. S11 ( 2022-12)
    Abstract: The COVID‐19 pandemic has impacted the wellbeing of older adults. Pandemic‐related stress has implications on cognitive status, including decline due to Alzheimer’s disease and related dementias. Yet, evidence suggests that COVID‐19 has impacted culturally and linguistically diverse communities differently. We sought to examine the role of COVID‐19 on coping and wellbeing in an international, multi‐ethnic sample of older adults. Method Data from 955 older adults (age = 66.7±7.9 years; education = 15.2±5.9 years; 71% female; 41% Hispanic/Latino) were pulled from a larger, international sample examining the response of older adults to COVID‐19. All participants completed demographic questionnaires, measures of psychological distress, the Brief‐COPE – a 28‐item self‐report questionnaire used to measure respondent’s efforts to minimize distress from a stressful life event – and the Epidemic‐Pandemic Impacts Inventory (EPII) – a 92‐item inventory of pandemic related experiences across several life domains. Using linear regression, we examined relationships between Brief‐COPE scores, ethnicity, and select EPII items controlling for several covariates (age, sex, education, marital status, number of children, employment status, household income, and history of COVID‐19 symptoms) in all analyses. Result Hispanic/Latino (H/L) ethnicity was associated with slightly higher scores on the approach‐focused coping subscale compared to the non‐Hispanic White (NHW) group (Approach: 27.3±6.6 vs 26.1±6.1; B = 1.205, p = 0.015, CI: 0.238, 2.172). There was no effect of ethnicity on Brief‐COPE Total or Avoidance subscale scores (both p s 〉 0.050). Notably, review of covariates suggested increased age was associated with lower scores on Approach (B = ‐0.065, p = 0.041, CI: ‐0.128, ‐0.003), Avoidance (B = ‐0.054, p = 0.034, CI: ‐0.104, ‐0.004), and Total scores (B = ‐0.136, p = 0.028, CI: ‐0.257, ‐0.015). Higher Approach scores were associated with greater endorsement of Positive Life Changes in both ethnic groups (NHW: partial r = 0.298, p 〈 0.001; H/L: partial r = 0.249, p 〈 0.036), but with endorsement of Mental Health Problems in NHWs only (NHW: partial r = 0.144; p = 0.001; H/L: partial r = ‐0.019, p 〉 0.050). Conclusion Findings suggest cross‐cultural differences in the stress coping response of older adults during the pandemic, even after controlling for symptomatic history and other relevant covariates. Moreover, coping may be differentially related to positive and negative outcomes across cultural groups. These results support the need to consider cultural background when considering coping and wellbeing in older adults.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2201940-6
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  • 7
    In: Alzheimer's & Dementia, Wiley, Vol. 19, No. S8 ( 2023-06)
    Abstract: The COVID‐19 pandemic has impacted daily life worldwide, with possible negative consequences for cognitive health. Self‐reported cognitive symptoms are linked to the development of Alzheimer’s disease and related dementias (ADRDs). Identifying risk and protective factors for cognitive symptoms during the pandemic is an important step towards the development of ADRD prevention efforts. We aimed to examine correlates of cognitive symptoms among middle‐ and older‐age adults in Latin America before the availability of vaccines to prevent COVID‐19, including sociodemographic factors and changes in life. Method Spanish‐speaking adults ages 55‐95 (N = 2,382, Table 1) living in Latin America completed an online survey between May and December 2020. Cognitive symptoms were assessed via the 12‐item Everyday Cognition (ECog) questionnaire. Negative (e.g., economic difficulties, limited social activities) and positive (e.g., more quality time with close others, increased time in nature/outside) life changes associated with the pandemic were measured via a subset of items from the Epidemic‐Pandemic Impacts Inventory. Sociodemographic factors included age, years of education, gender, occupation and socioeconomic status (SES). Covariates included time since March 2020 (estimated onset of the pandemic in Latin America), country of survey completion, and having experienced COVID‐19 symptoms. Multivariable linear regression models were ran on ECog total scores including covariates and sociodemographic factors (Model 1), and then adding terms for negative and positive life changes and their interaction (Model 2). Results Model 1 showed female gender (p = .04), not currently working (p = .02) and lower SES (p 〈 .001) were independently associated with more cognitive symptoms. Model 2 showed a significant interaction between negative and positive life changes (p 〈 .001), indicating that negative life changes were significantly associated with more cognitive symptoms, but this association was weaker among participants who reported at least one positive life change during the pandemic (Figure 1). Conclusion Cognitive symptoms might be more common among certain segments of the Latin American population, including women, and those who are not working and have low SES. The experience of positive life changes during the pandemic might buffer the detrimental impact of negative life changes on cognitive symptoms. These risk and protective factors might be considered in ADRD prevention efforts.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2201940-6
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  • 8
    In: Salud mental, Instituto Nacional de Psiquiatria Ramon de la Fuente Muniz, Vol. 42, No. 6 ( 2019-12-27), p. 281-287
    Abstract: Introducción. Los problemas de la memoria “episódica” son comunes en las personas con deterioro cognitivo tipo Alzheimer. Dubois et al. desarrollaron la Prueba de Cinco Palabras (P5P) para evaluar la memoria episódica, la cual ha demostrado ser sencilla y válida para identificar trastornos cognitivos. Sin embargo, su validación y adaptación cultural del francés al español no se ha realizado y se desconoce su utilidad en población mexicana. Objetivo. Validación y adaptación cultural de la P5P para el tamizaje del trastorno neurocognitivo (TNC) menor y mayor en adultos mayores mexicanos con probable enfermedad de Alzheimer. Método. Participaron 215 participantes (70 cognitivamente sanos, 73 con TNC menor y 72 con TNC mayor. El estado cognitivo (estándar de oro) se determinó mediante los criterios clínicos vigentes y de evaluación neuropsicológica. El coeficiente de Spearman, la curva ROC y modelos de regresión logística multinomial se utilizaron para determinar la validez concurrente de la P5P. Resultados. La correlación entre la P5P y el MMSE fue de .58, mientras que para la prueba de reloj fue de -.37 (p 〈 .001). El área bajo la curva de la P5P fue .97 (IC 95% [.94, .99]), con un punto de corte ≤ 16/20 para el diagnóstico del TNC mayor (sensibilidad: 89%, especificidad: 98%) y de .77 (IC 95% [.70, .85] ) para el TNC menor con un punto de corte ≤ 18/20 (sensibilidad: 66%, especificidad: 77%). Discusión y conclusión. La P5P es un instrumento válido y simple para identificar de trastornos neurocognitivos de tipo Alzheimer por lo que podría ser una prueba práctica para uso en el tamizaje.
    Type of Medium: Online Resource
    ISSN: 0185-3325
    Language: English
    Publisher: Instituto Nacional de Psiquiatria Ramon de la Fuente Muniz
    Publication Date: 2019
    detail.hit.zdb_id: 2067719-4
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  • 9
    Online Resource
    Online Resource
    Frontiers Media SA ; 2021
    In:  Frontiers in Neurology Vol. 12 ( 2021-9-9)
    In: Frontiers in Neurology, Frontiers Media SA, Vol. 12 ( 2021-9-9)
    Abstract: Background: Alzheimer's disease (AD) animal models have shown a reduced gamma power in several brain areas, and induction of these oscillations by non-invasive methods has been shown to modify several pathogenic mechanisms of AD. In humans, the application of low-intensity magnetic fields has shown to be able to produce neural entrainment at the magnetic pulse frequency, making it useful to induce gamma frequencies. Objective: The aim of this study was to assess if the application of fast gamma magnetic stimulation (FGMS) over the left prefrontal dorsolateral cortex would be a safe and well-tolerated intervention that could potentially improve cognitive scores in subjects with mild cognitive impairment and mild AD. Methods: In these randomized, double-blind, sham-controlled study, participants were assigned to either receive daily sessions two times a day of active or sham FGMS for 6 months. Afterward, measurements of adverse effects, cognition, functionality, and depression were taken. Results: Thirty-four patients, 17 in each group, were analyzed for the primary outcome. FGMS was adequately tolerated by most of the subjects. Only four patients from the active FGMS group (23.52%) and one patient from the sham FGMS group (5.88%) presented any kind of adverse effects, showing no significant difference between groups. Nevertheless, FGMS did not significantly change cognitive, functionality, or depressive evaluations. Conclusion: FGMS over the left prefrontal dorsolateral cortex applied twice a day for 6 months resulted to be a viable intervention that can be applied safely directly from home without supervision of a healthcare provider. However, no statistically significant changes in cognitive, functionality, or depression scores compared to sham stimulation were observed. Clinical Trial Registration: www.ClinicalTrials.gov , Identifier: NCT03983655, URL: https://clinicaltrials.gov/ct2/show/NCT03983655 .
    Type of Medium: Online Resource
    ISSN: 1664-2295
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2021
    detail.hit.zdb_id: 2564214-5
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  • 10
    In: Alzheimer's & Dementia, Wiley, Vol. 18, No. S7 ( 2022-12)
    Abstract: SARS‐CoV2 infection affects the central nervous system, one of the manifestations is the cognitive function impairment (1,2). It is currently unknown to what degree and which cognitive domains are involved in this disease (3,4). This study aims to know the effect on global cognitive function in older adults recovered of COVID‐19 Method A prospective cohort study recruited adults aged over 60 years old. As dependent variable, the Global Cognitive Function (GCF) was assessed using the Mini‐Mental State Examination (MMSE) test via telemedicine in patients recovered of moderate and severe COVID‐19 6 months after hospital discharge. Patients with uncontrolled neurological, metabolic, and psychiatric diseases were excluded. Multivariate models were constructed, as well as Cox regression model to assess the association between GCF impaired with history of moderate and severe COVID‐19, adjusted for age, sex, and education Result We studied 607 patients, of which 108 survived the SARS‐CoV‐2 infection. One patient dies during the follow‐up. 107 patients were analyzed, median age was 70 years (SD 7.3), 54% were women, with 9.2 (SD 3.8) years of education, the mean of MMSE was 26.2 (SD 3.2). Regarding the severity of the COVID‐19, 74% presented a moderate infection and 26% was severe. 12% had GCF impaired, of which 14.3% were severe COVID‐19 and 11.4% with moderate infection. Cognitive domains most affected were episodic memory (43%) and constructional praxis (86%) in all patients, without statistic difference for infection severity. Factors associated with GCF impaired was the history of depression (HR 6.8; 95%CI: 1.4‐31.5, p = 0.01), higher education (HR ‐0.20; 95%CI: 0.68‐0.95, p = 0.01), and C‐RP level (HR 1.07; 95%CI: 1.01‐1.13, p = 0.01) Conclusion Global cognitive function in older adults recovered of severe COVID‐19 was impaired 6 months after hospital discharge. Cognitive domains of episodic memory and constructive praxis were the most altered. Future studies are needed in this geriatric population to confirm this long‐term outcome, especially in those patients with risk factors such as history of depression, lower education, and severe illness
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2201940-6
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